Methods and compositions for gamma-glutamyl cycle modulation

ABSTRACT

The present disclosure provides pharmaceutical compositions comprising Gamma-glutamyl cycle inhibitors (GGCI) and certain pharmaceutically acceptable salts thereof, and methods of use.

RELATED APPLICATION

This application is a divisional application of U.S. application Ser.No. 15/495,496, filed on Apr. 24, 2017, which is a divisionalapplication of U.S. application Ser. No. 14/214,888, filed on Mar. 15,2014, and claims priority to U.S. Provisional Application No.61/801,709, entitled Methods and Compositions for Gamma-Glutamyl CycleModulation, filed Mar. 15, 2013, the contents of each which are hereinincorporated by reference as if set forth in their entirety.

FIELD

The present disclosure is generally related to novel compounds of thegeneral formula I and pharmaceutically acceptable salts or estersthereof. The present disclosure also relates to pharmaceuticalcompositions containing them, methods of making the above compounds, andtheir use as gamma-glutamyl cycle inhibitors (GGCI), which are useful inthe treatment or prevention of diseases, particularly malignancies,complications related to malignancies, and other pathogenic conditionsin which the gamma-glutamyl cycle (GGC) is implicated. In particular,the disclosure provides methods and compositions for the treatment ofmalignancies by modulating the gamma-glutamyl cycle and the de novobiosynthesis of glutathione.

BACKGROUND

The following includes information that may be useful in understandingvarious aspects and embodiments of the present disclosure. It is not anadmission that any of the information provided herein is prior art, orrelevant, to the presently described or claimed inventions, or that anypublication or document that is specifically or implicitly referenced isprior art.

The gamma-glutamyl cycle (GGC) (FIG. 2) is a biosynthetic pathway thatis present in almost every living cell. It enables the transport ofamino acids, transferrin, iron, and other moieties from outside a livingcell, through the cell membrane, into the cytoplasm. Some of the aminoacids are essential for the de novo biosynthesis of glutathione. The GGCfor the biosynthesis of glutathione. The GGC does not require insulin asa cofactor.

Glutathione (GSH) biosynthesis is catalyzed by γ-glutamylcysteinesynthetase (GGCS) and glutathione synthetase (GS), two enzymes in thegamma-glutamyl cycle. The cellular cysteine concentration and GGCSlevels are rate-limiting. GGCS is feedback inhibited by GSH, leading toa steady state in cellular GSH.

Gamma-glutamyl transpeptidase (GGT) catalyzes two reactions: hydrolysisof a γ-glutamyl bond and transpeptidation (TP). GGT is induced to highlevels in many pre-neoplastic lesions (altered hepatic foci, AHF) atearly stages of hepatocarcinogenesis (HC) in rodents. The ubiquity ofelevated GGT levels in many rodent and human hepatic and extrahepaticcarcinomas have led to the hypothesis that GGT provides a growthadvantage to focal cells during carcinogenesis. Because GGT participatesin detoxification of xenobiotics, the growth advantage has beensuggested to result from resistance to the acute toxicity ofcarcinogens.

SUMMARY OF THE INVENTION

Although there are many established therapeutic agents directed tocancer therapy, it was recognized by the inventors that the novelstereoisomeric compounds of this disclosure are useful as cancertherapeutics.

The present disclosure provides synthetic methods, novel analogs of5-oxoproline, and pharmaceutical formulations and kits comprising theanalogs. The compounds and pharmaceutical formulations are useful forcancer therapeutics that target 5-oxoprolinase, an enzyme in thegamma-glutamyl cycle. Blocking of the enzyme 5-oxoprolinase blocks celldivision of hyperproliferative cells, such as cancer cells, byinterfering with the transport of essential amino acids into the celland the synthesis of glutathione and other biosynthesis products of thegamma-glutamyl cycle. The methods and compositions are useful forcontrolling tumor progression, drug resistance and drug targeting.Accordingly, the disclosure provides methods of synthesizing and usingmodulators/inhibitors of the gamma-glutamyl cycle and of the de novobiosynthesis of glutathione, which are useful in the treatment ofmalignancies. Specifically, the compositions and methods of use thereofare provided to disrupt the conversion of 5-oxoproline to glutamic acidby 5-oxoprolinase.

In one aspect, the present disclosure provides a stereoisomeric compoundrepresented by formula (I):

or an ester and/or pharmaceutically acceptable salt thereof, wherein:

-   -   R is independently selected from optionally substituted aryl,        heteroaryl, para-methoxyphenyl, methyl carbonyl,        2,6-dimethyl-1,5-heptadienyl, 2,6-dimethyl-5-heptenyl,        ortho-hydroxy phenyl, phenyl, and 3-aldehyde-propyl;    -   R₂ is independently selected from the group consisting of H,        COOH; glucose esters, and glucuronic acid esters;    -   R₃ and R₄ are independently selected from H, methyl or lower        alkyl; and    -   S is independently selected from the group consisting of        optionally substituted sulfur, selenium, tellurium, or oxygen.

The compounds of formula I can be used in the methods of this inventionas described herein. R may be obtained by the reaction of a suitablealdehyde in the methods of synthesis described herein. The aldehyde maybe, for example, any substituted aryl-CHO or heteroaryl-CHO, pyruvicaldehyde, citral, citronellal, salicylaldehyde, benzaldehyde, glutaricdialdehyde, or p-methoxylbenzaldehyde.

In some embodiments, R and S are as described above, and R₂ isindependently selected from the group consisting of COOH; glucoseesters, and glucuronic acid esters, and R₃ and R₄ are independentlyselected from methyl or lower alkyl. In some embodiments, R₂ is COOH,and R₃ and R₄ are H. In some embodiments, where R3 and R4 are H, R isnot ortho-hydroxyphenyl. In some embodiments, R2 can be COOR5, where R5is a lower alkyl ester. In that embodiment, where R3 and R4 are methyl,and R is ortho-hydroxyphenyl, R5 is not methyl.

In one embodiment, the present disclosure relates to a compound andsalts, and crystals, and polymorphs thereof, having the formula (II):

wherein the R₁ is —OCH₃, and R₂, R₃, and R₄. are as above for formula(I). In one embodiment, the compound or salts, crystals, and polymorphsthereof, having the formula (III), also referred to herein as PMB-GGCIor MBDTA:

In one embodiment, the present disclosure relates to a compound andsalts, crystals, and polymorphs thereof, having the formula (IV), alsoreferred to herein as SA-GGCI when R2 is COOH and R3 and R4 are methyl:

In one embodiment, the present disclosure relates to a compound andsalts, and crystals, and polymorphs thereof, having the formula (V),also referred to herein as BA-GGCI when R2 is COOH and R3 and R4 aremethyl:

In the compounds of this invention, the carbon to which the carboxylgroup is attached is in the (L) conformation. Reference to (L) and (D)compounds of this disclosure herein refers to the stereochemicalconformation at the carbon adjacent to the R2 group in the compounds ofFormula I-V or the carbon adjacent to the COOH group in Formula III. Inone embodiment, when the p-methoxy benzyl ring is unsubstituted, thecompound is (1L)-2-imino-3-p-methoxybenzyl-4 sulfanyl-5,5 dimethyl1-carboxylic acid, which is alternatively named or(4L)-3-imino-2-p-methoxybenzyl-1 sulfanyl-5,5 dimethyl 4-carboxylicacid, or (4L)-2-p-methoxybenzyl-5,5-dimethyl-4-thiazolidinecarboxylicacid (MBDTA). In one embodiment, the compounds of this disclosure may beobtained by conjugating 3,3 dimethyl-(L)-cysteine, i.e.,(L)-penicillamine, other (L)-cysteine analogs or cystamine with asuitable aldehyde to generate the stereoisomeric compounds of thisinvention.

In some embodiments the S atom in the heterocyclic ring can be replacedwith selenium, tellurium or oxygen. In one embodiment the thiazolidinering has a dimethyl substituent for optimal activity. In anotherembodiment, the 5 position of the thiazolidine ring is substituted witha methyl and a hydrogen.

D-penicillamine (often referred to as penicillamine) is a drug used toremove copper in patients, for example in patients with Wilson'sDisease, a genetic disorder of copper metabolism. Certain aldehydeconjugates of D-penicillamine have been described for use ascopper-chelating inhibitors of tyrosinase. See U.S. Pat. No. 5,169,858.

However, in contrast to D-penicillamine, the L-penicillaminestereoisomer is toxic, and has not been approved as a drug. It wastherefore suprisingly found by the inventors that the (L)-gamma-glutamylcycle inhibitors (GGCIs) of this disclosure exhibit unexpected lowtoxicity. In certain embodiments, the inventors surprisingly discoveredthat when L-isomers of penicillamine were used as a starting material,the resultant GGCI synthesized using the synthetic scheme as describedherein resulted in high yield synthesis of compounds having potentefficacy, and low toxicity, whereas the use of D-isomers ofpenicilalmine as starting material yielded compounds having no efficacy.More specifically, it was suprisingly found by the inventors that the(L) conformation compounds of this invention exhibited surprisingly highlevels of anti-cancer activity in animal models and in compassionate usetreatment of human subjects, while the (D) conformation compounds hadminimal or no activity. For example, the inventors observed that(L)-MBDTA has potent anti-tumor activity while the (D) stereoisomer hasno activity. Moreover, when the inventors compared the relativeactivities, the (L) conformation compounds of this disclosure appearedto be at least 2× as active as the corresponding racemate, due to theimproved stereospecificity in the enzymatic catalysis of 5-oxoproline by5 oxoprolinase.

In one aspect, the present disclosure provides a pharmaceuticalcomposition comprising any GGCI disclosed herein and a pharmaceuticallyacceptable excipient. In another aspect, the present disclosure providesa composition for selectively treating tumor cells comprising aneffective amount of a 5-oxoproline analog, whereby the analog istransported into the cell and binds to, but is not metabolized by,5-oxoprolinase. The compounds of this invention are effective ininhibiting the synthesis of glutamic acid in the gamma-glutamyl cycle.In one embodiment, the composition inhibits the production of substratefor glutathione-S-transferase. In one embodiment, the compositioninhibits glutathione-S-transferase comprised of2-imino-3-p-methoxybenzyl-4 sulfanyl-5 dimethyl 1-carboxylic acid. Inone embodiment, the composition comprises a GGCI salt and polymorphsthereof. In one embodiment, an isolated GGCI chloride salt that has apurity range selected from the group consisting of 50%, 55%, 60% pure,65%, 70%, 75%, 80%, 85%, 90%, 95%, 98%, 99% or 100% pure is provided. Inone embodiment, a substantially pure GGCI anhydrate, dihydrate,trihydrate, or tetrahydrate is provided. In one embodiment, acomposition comprising a substantially pure GGCI crystal havingalternating layers of GGCI molecules and mesylate molecules (mesylatesalt), and a pharmaceutically acceptable carrier is provided.

In one aspect, the present disclosure provides the use of a compound ofany of formulas I-V for the preparation of a medicament for thetreatment of a condition selected from the group consisting of cancer,hyperplasia, and neoplasia. In one embodiment, the MDR is therebyinhibited and/or reduced. In one embodiment, the tumor progression isthereby inhibited and/or reduced. In one embodiment, the exemplarycompounds bind sugar moieties and/or have high affinity lectin activity.

In one aspect the present disclosure provides a method of treatingcancer comprising administering to a subject in need thereof atherapeutically effective amount of a pharmaceutical compositioncomprising a GGCI of formulas I-V, whereby gamma-glutamyl cycle isinhibited. In one embodiment, the GGCI is a 5-oxoproline analog. In oneembodiment, the 5-oxoproline analog is 2-imino-3-p-methoxybenzyl-4sulfanyl-5,5 dimethyl 1-carboxylic acid. In one embodiment, inhibitionof the GGC results from the inhibition of biosynthesis by the GGC, forexample, the inhibition of production of a product, an intermediate, ora metabolite of the GGC pathway.

In one embodiment, the level of glutathione is reduced in cancer cells.In one embodiment, the compounds of this invention inhibitglutathione-S-transferase, for example, by inhibiting production of itssubstrate. Glutathione protects cells from oxidative stress, includingdetoxifying reactive alkylating agents and oxidizing agents, and helpsto block the damaging effects of therapeutic alkylating agents and/oroxidizing agents on cancer cells. In certain embodiments, the GGCI canbe administered synergistically with an alkylating agent and/oroxidizing agents that can increases the risk/damage to cancer cells. Incertain embodiments, the GGCIs of this invention can be administered incombination with an inhibitor of glutathoine-S-transferase tosynergistically inhibit the GGC. For example, any of the compounds ofthis invention can be advantageously administered simultaneously and/orsequentially with turmeric extract and/or tacrinic acid. In certainembodiments, the GGCI can be used to prevent or diminish resistance toone or more cancer therapeutics, and/or to reduce the metabolicbreakdown of alkylating and/or oxiding cancer therapeutics, permittinglowering of the dose and reduction of side effects.

In one aspect, the effective dose of GGCI is from 2 to 5 g/kg, forexample, 4 g/kg. In another aspect, the effective dose of GGCI is givenin one or more doses of 3.5 g/kg for each dose. In certain embodiments,the one or more effective doses of GGCI are administered subcutaneously.In one embodiment, the one or more effective doses of GGCI areadministered intravenously. In one embodiment, the one or more effectivedoses of GGCI are administered intramuscularly. In one embodiment, theone or more effective doses of GGCI are administered orally. In oneembodiment, the cancer is a solid tumor. In one embodiment, thetreatment comprises treatment of solid tumors. In one embodiment, thetumors comprises sarcomas, carcinomas or lymphomas. In one embodiment,the cancer is selected from the group consisting of: lung, breast,prostate, pancreatic, ovarian, bladder, head and neck, thyroid, brain,skin and kidney. In one embodiment, the dose is administered by adelivery route selected from the group consisting of intraperitoneal,intradermal, intramuscular, intraperitoneal, intravenous, topical,subcutaneous, intranasal, oral, or epidural routes.

In one aspect, the present disclosure provides a method of synthesizingthe compound of formula I, and salts thereof, wherein the compound isobtained by: the synthesis scheme of FIG. 1. In one embodiment,(L)-2-imino-3-p-methoxybenzyl-4 sulfanyl-5 dimethyl 1-carboxylic acidwas synthesized. In one embodiment, equimolar quantities of methoxytoluene (p-methoxybenzaldehyde), di-methyl cysteine and manganesedioxide were dissolved in two liters of 70% ethanol. In one embodiment,the mixture was made in a rotary evaporator and the temperature wasraised to 70° C. In one embodiment, after about 1 hour, all theingredients dissolved. In one embodiment, the volume was then reduced byone liter. In one embodiment, the solution was left in the flask to cooldown overnight to room temperature. In one embodiment, the precipitatingwhite crystals of GCI were filtered and then dried in a vacuum ovenafter one day. In one embodiment, the disclosure provides intermediatesfor said synthesis scheme of FIG. 1.

In other embodiments, the appropriate substituted cysteine, cystamineand aldehyde may be reacted in the synthetic schemes of FIG. 1 to obtainthe desired compound. The aldehyde may be, for example, any substitutedaryl-CHO or heteroaryl-CHO, pyruvic aldehyde, citral, citronellal,salicylaldehyde, benzaldehyde, glutaric dialdehyde, orp-methoxylbenzaldehyde. In one embodiment, the (L)-isomer of cysteine orsubstituted cysteine (or a tellurium or oxygen analog thereof) is usedas a starting reactant to obtain an enantiomer of the compound offormula (I) having a specific stereochemistry at the carbon to which theR2 group, or the carboxylic acid group, is attached. Exemplary reactantscan include (L)-penicillamine, (L)-cysteine, and cystamine.

According to one aspect of the present invention, there are providednovel compounds represented by the general formula (I), their racemates,their pharmaceutically acceptable salts, and pharmaceutical compositionscontaining them, or mixture thereof.

In another aspect, the present invention provides a process for thepreparation of novel organic compounds of the general formula (I), theirracemates, their pharmaceutically acceptable salts, and pharmaceuticalcompositions containing them.

A further aspect of the present invention is to provide novelintermediates, a process for their preparation, and their use in methodsof making compounds of the general formula (I).

In one embodiment, the present disclosure is related to the stereometriccompounds of the general formula I, their esters, racemates, andpharmaceutically acceptable salts thereof, wherein R is independentlyselected from optionally substituted aryl, heteroaryl,para-methoxyphenyl, methyl carbonyl, 2,6-dimethyl-1,5-heptadienyl,2,6-dimethyl-5-heptenyl, 2-hydroxy phenyl, phenyl, and3-aldehyde-propyl; R2 is independently selected from the groupconsisting of COOH; and esterified glucose or glucuronic acid; R3 and R4are independently selected from methyl or lower alkyl; and S isindependently selected from the group consisting of optionallysubstituted sulfur, selenium tellurium or oxygen. In some instances,when salicylaldehyde (SA) or benzaldehyde (BA) is used to obtain theexemplary Formula I-V compounds of this invention, a synergisticanalgesic effect may also be obtained when treating subjects byadministering those compounds according to the methods herein. In someembodiments, the exemplary compounds of formulae I-V can also besynthesized using exemplary starting compounds, such as, for example,(L)-penicillamine, (L)-cysteine, and cystamine.

In one aspect, this disclosure provides a method of treatment comprisingadministering to a subject in need thereof an effective amount of apharmaceutical composition comprising GGCI.

In one embodiment, the subject has a solid tumor cancer. In anotheraspect, the solid tumor comprises sarcomas, carcinomas or lymphomas. Inanother embodiment, the cancer is selected from the group consisting of:lung, breast, prostate, pancreatic, ovarian, bladder, head and neck,thyroid, brain, liver, gallbladder, skin, colon, and kidney. In oneembodiment, the solid tumor is a poorly reoxygenating tumor.

In one aspect, each dose of GGCI is between about 1 ng/kg and less toabout 10 g/kg, and said dose is administered by a delivery routeselected from the group consisting of intraperitoneal, intradermal,intramuscular, intramuscular, intravenous, parenteral, intranasal,intracranial, topical, subcutaneous, oral, and epidural routes.

The inventions described and claimed herein have many attributes andembodiments, including, but not limited to, those set forth, ordescribed, or referenced, in this Brief Summary. It is not intended tobe all-inclusive and the inventions described and claimed herein are notlimited to, or by the features or embodiments identified in, this BriefSummary, which is included for purposes of illustration only and notrestriction. Additional embodiments may be disclosed in the DetailedDescription below.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 depicts representative synthetic schemes for making exemplaryGGCI/5-oxoproline analogs.

FIG. 2 is a diagram showing the GGC biochemical pathway.

FIGS. 3A and 3B are comparative images of tumor sizes between thecontrol group and the GGCI treated group of nude mice engrafted withhuman malignant melanoma. FIG. 3A is the control group after 120 days.FIG. 3B is the treated group after 120 days.

FIGS. 4A and 4B are comparative images of tumor sizes between thecontrol group and the GGCI treated group of nude mice engrafted withhuman lung cancer. FIG. 4A is the control group after 120 days. FIG. 4Bis the treated group after 120 days.

DETAILED DESCRIPTION

Accordingly, the present disclosure relates generally to novelgamma-glutamyl cycle inhibitors. The disclosure is based on the higheractivity of the enzyme gamma-glutamyl transpeptidase found in cancerouscells and the substantially faster dividing rate of cancerous cellscompared to cells of the non-cancerous origin. Inhibition of the GGC,for example, by blocking and/or interfering with one or more enzymes ofthe GGC, can lead to suppression of cancer cell growth and reduction inthe number of cancer cells. The inhibition of the GGC can be achieved bypresenting a “false metabolite” competitive inhibitor of an enzyme inthe gamma-glutamyl cycle, which preferentially effects rapidly dividingcells, such as cancer cells. By doing so, the GGCI of this disclosurecan have more deleterious effects on cancer cells than to thenon-cancerous ones.

In one aspect, this disclosure relates to the synthesis of the novelinhibitors of this disclosure that compete with 5-oxoproline for binding5-oxoprolinase, thereby reducing and/or inhibiting biosynthesis by otherenzymes in the gamma-glutamyl cycle through substrate depletion. Thisblocks GGC mediated amino acid transport into the cell and interfereswith cell division. In addition, the GGCIs of this invention furtherinterfere with GGC synthesis of glutathione. Since cancerous cells needsubstantially more amino acids to support a much faster doubling timethan non-cancerous cells, the GGCIs of this invention willpreferentially damage cancerous cells.

Definitions

The term “alkyl” includes saturated aliphatic groups, includingstraight-chain alkyl groups (e.g., methyl, ethyl, propyl, butyl, pentyl,hexyl, heptyl, octyl, nonyl, decyl, etc.), branched-chain alkyl groups(isopropyl, tert-butyl, isobutyl, etc.), cycloalkyl (alicyclic) groups(cyclopropyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl), alkylsubstituted cycloalkyl groups, and cycloalkyl substituted alkyl groups.The term alkyl further includes alkyl groups, which comprise oxygen,nitrogen, sulfur, or phosphorous, atoms replacing one or more carbons ofthe hydrocarbon backbone. The term “aromatic-alkyl” includes alkylgroups substituted with one or more aryl groups. The term “lower alkyl”as used herein refers to [3 or fewer carbons].

The term “aryl” includes groups with aromaticity, including 5- and6-membered single-ring aromatic groups that may include from zero tofour heteroatoms, as well as multicyclic systems with at least onearomatic ring. Examples of aryl groups include benzene, phenyl, pyrrole,furan, thiophene, thiazole, isothiazole, imidazole, triazole, tetrazole,pyrazole, oxazole, isooxazole, pyridine, pyrazine, pyridazine, andpyrimidine, and the like. Furthermore, the term “aryl” includesmulticyclic aryl groups, e.g., tricyclic, bicyclic, e.g., naphthalene,benzoxazole, benzodioxazole, benzothiazole, benzoimidazole,benzothiophene, methylenedioxyphenyl, quinoline, isoquinoline,napthridine, indole, benzofuran, purine, benzofuran, deazapurine, orindolizine. Those aryl groups having heteroatoms in the ring structuremay also be referred to as “aryl heterocycles”, “heterocycles,”“heteroaryls” or “heteroaromatics”. The aromatic ring can be substitutedat one or more ring positions with such substituents as described above,as for example, halogen, hydroxyl, alkoxy, alkylcarbonyloxy,arylcarbonyloxy, alkoxycarbonyloxy, aryloxycarbonyloxy, carboxylate,alkylcarbonyl, alkylaminocarbonyl, aralkylaminocarbonyl,alkenylaminocarbonyl, alkylcarbonyl, arylcarbonyl, aralkylcarbonyl,alkenylcarbonyl, alkoxycarbonyl, aminocarbonyl, alkylthiocarbonyl,phosphate, phosphonato, phosphinato, cyano, amino (including alkylamino,dialkylamino, arylamino, diarylamino, and alkylarylamino), acylamino(including alkylcarbonylamino, arylcarbonylamino, carbamoyl and ureido),amidino, imino, sulfhydryl, alkylthio, arylthio, thiocarboxylate,sulfates, alkylsulfinyl, sulfonato, sulfamoyl, sulfonamido, nitro,trifluoromethyl, cyano, azido, heterocyclyl, alkylaryl, or an aromaticor heteroaromatic moiety. Aryl groups can also be fused, or bridged,with alicyclic or heterocyclic rings which are not aromatic, so as toform a multicyclic system (e.g., tetralin, methylenedioxyphenyl).

The term “alkylene” refers to divalent saturated aliphatic groups andincludes both straight chain and branched chain groups.

The term “alkenylene” refers to divalent aliphatic groups having adouble bond and includes both straight chain and branched chain groups.

As used herein, a “subject” refers to an animal that is the object oftreatment, observation or experiment. “Animal” includes cold- andwarm-blooded vertebrates and invertebrates, such as fish, shellfish,reptiles and, in particular, mammals. “Mammal” includes, withoutlimitation, mice; rats; rabbits; guinea pigs; dogs; cats; sheep; goats;cows; horses; primates, such as monkeys, chimpanzees, apes, andprenatal, pediatric, and adult humans.

As used herein, “preventing” or “protecting” means preventing in wholeor in part, or ameliorating, or controlling.

As used herein, the term “treating” refers to both therapeutic treatmentand prophylactic, or preventative, measures, or administering an agentsuspected of having therapeutic potential. The term includespreventative (e.g., prophylactic) and palliative treatment.

The term “a pharmaceutically effective amount”, as used herein, means anamount of active compound, or pharmaceutical agent, that elicits thebiological, or medicinal, response in a tissue, system, animal, or humanthat is being sought, which includes alleviation or palliation of thesymptoms of the disease being treated and/or an amount sufficient tohave utility and provide desired therapeutic endpoint. In the case ofcancer, the therapeutically effective amount of the drug may reduce thenumber of cancer cells; reduce the tumor size; inhibit (i.e., slow tosome extent and preferably stop) cancer cell infiltration intoperipheral organs; inhibit (i.e., slow to some extent and preferablystop) tumor metastasis; inhibit, to some extent, tumor growth; and/orrelieve to some extent one or more of the symptoms associated with thecancer. To the extent the drug may prevent growth and/or kill existingcancer cells, it may be cytostatic and/or cytotoxic. For cancer therapy,efficacy can be measured, e.g., by assessing the time to diseaseprogression and/or determining the response rate.

The term “pharmaceutically acceptable”, as used herein, means that thesubstance or composition must be compatible chemically and/ortoxicologically, with the other ingredients comprising a formulation,and/or the mammal being treated therewith.

The term “cancer” refers to, or describes, the physiological conditionin mammals that is typically characterized by unregulated cell growthand/or hyperproliferative activities. A “tumor” comprises one or morecancerous cells. Examples of cancer include, but are not limited to,carcinoma, lymphoma, blastoma, sarcoma, and leukemia or lymphoidmalignancies. More particular examples of such cancers include squamouscell cancer (e.g., epithelial squamous cell cancer), lung cancer,including small-cell lung cancer, non-small cell lung cancer (“NSCLC”),adenocarcinoma of the lung and squamous carcinoma of the lung, cancer ofthe peritoneum, hepatocellular cancer, gastric or stomach cancerincluding gastrointestinal cancer, pancreatic cancer, glioblastoma,cervical cancer, ovarian cancer, liver cancer, bladder cancer, hepatoma,breast cancer, colon cancer, rectal cancer, colorectal cancer,endometrial or uterine carcinoma, salivary gland carcinoma, kidney orrenal cancer, prostate cancer, vulval cancer, thyroid cancer, hepaticcarcinoma, anal carcinoma, penile carcinoma, as well as head and neckcancer.

A “chemotherapeutic agent” is a chemical compound useful in thetreatment of cancer, regardless of mechanism of action. Classes ofchemotherapeutic agents include, but are not limited to: alkyatingagents, antimetabolites, spindle poison plant alkaloids,cytoxic/antitumor antibiotics, topoisomerase inhibitors, antibodies,photosensitizers, and kinase inhibitors. Chemotherapeutic agents includecompounds used in “targeted therapy” and conventional chemotherapy.Examples of chemotherapeutic agents include: erlotinib (TARCEVA®,Genentech/OSI Pharm.), docetaxel (TAXOTERE®, Sanofi-Aventis), 5-FU(fluorouracil, 5-fluorouracil, CAS No. 51-21-8), gemcitabine (GEMZAR®,Lilly), PD-0325901 (CAS No. 391210-10-9, Pfizer), cisplatin(cis-diamine, dichloroplatinum(II), CAS No. 15663-27-1), carboplatin(CAS No. 41575-94-4), paclitaxel (TAXOL®, Bristol-Myers Squibb Oncology,Princeton, N.J.), pemetrexed (ALIMTA®, Eli Lilly), trastuzumab(HERCEPTIN®, Genentech), temozolomide(4-methyl-5-oxo-2,3,4,6,8-pentazabicyclo[4.3.0]nona-2,7,9-triene-9-carboxamide,CAS No. 85622-93-1, TEMODAR®, TEMODAL®, Schering Plough), tamoxifen((Z)-2-[4-(1,2-diphenylbut-1-enyl)phenoxy]-N,N-dimethylethanamine,NOLVADEX®, ISTUBAL®, VALODEX®), and doxorubicin (ADRIAMYCIN®), Akti-1/2,HPPD, and rapamycin.

More examples of chemotherapeutic agents include: oxaliplatin(ELOXATIN®, Sanofi), bortezomib (VELCADE®, Millennium Pharm.), sutent(SUNITINIB®, SU11248, Pfizer), letrozole (FEMARA®, Novartis), imatinibmesylate (GLEEVEC®, Novartis), XL-518 (Mek inhibitor, Exelixis, WO2007/044515), ARRY-886 (Mek inhibitor, AZD6244, Array BioPharma, AstraZeneca), SF-1126 (PI3K inhibitor, Semafore Pharmaceuticals), BEZ-235(PI3K inhibitor, Novartis), XL-147 (PI3K inhibitor, Exelixis), PTK787/ZK222584 (Novartis), fulvestrant (FASLODEX®, AstraZeneca), leucovorin(folinic acid), rapamycin (sirolimus, RAPAMUNE®, Wyeth), lapatinib(TYKERB®, GSK572016, Glaxo Smith Kline), lonafarnib (SARASAR™, SCH66336, Schering Plough), sorafenib (NEXAVAR®, BAY43-9006, Bayer Labs),gefitinib (IRESSA®, AstraZeneca), irinotecan (CAMPTOSAR®, CPT-11,Pfizer), tipifarnib (ZARNESTRA™, Johnson & Johnson), ABRAXANE™(Cremophor-free), albumin-engineered nanoparticle formulations ofpaclitaxel (American Pharmaceutical Partners, Schaumberg, II),vandetanib (rINN, ZD6474, ZACTIMA®, AstraZeneca), chloranmbucil, AG1478,AG1571 (SU 5271; Sugen), temsirolimus (TORISEL®, Wyeth), pazopanib(GlaxoSmithKline), canfosfamide (TELCYTA®, Telik), thiotepa andcyclosphosphamide (CYTOXAN®, NEOSAR®); alkyl sulfonates such asbusulfan, improsulfan and piposulfan; aziridines such as benzodopa,carboquone, meturedopa, and uredopa; ethylenimines and methylamelaminesincluding altretamine, triethylenemelamine, triethylenephosphoramide,triethylenethiophosphoramide and trimethylomelamine; acetogenins(especially bullatacin and bullatacinone); a camptothecin (including thesynthetic analog topotecan); bryostatin; callystatin; CC-1065 (includingits adozelesin, carzelesin and bizelesin synthetic analogs);cryptophycins (particularly cryptophycin 1 and cryptophycin 8);dolastatin; duocarmycin (including the synthetic analogs, KW-2189 andCB1-TM1); eleutherobin; pancratistatin; a sarcodictyin; spongistatin;nitrogen mustards such as chlorambucil, chlornaphazine,chlorophosphamide, estramustine, ifosfamide, mechlorethamine,mechlorethamine oxide hydrochloride, melphalan, novembichin,phenesterine, prednimustine, trofosfamide, uracil mustard; nitrosoureassuch as carmustine, chlorozotocin, fotemustine, lomustine, nimustine,and ranimnustine; antibiotics such as the enediyne antibiotics (e.g.,calicheamicin, calicheamicin gammalI, calicheamicin omegaI1 (Angew Chem.Intl. Ed. Engl. (1994) 33:183-186); dynemicin, dynemicin A;bisphosphonates, such as clodronate; an esperamicin; as well asneocarzinostatin chromophore and related chromoprotein enediyneantibiotic chromophores), aclacinomysins, actinomycin, authramycin,azaserine, bleomycins, cactinomycin, carabicin, caminomycin,carzinophilin, chromomycinis, dactinomycin, daunorubicin, detorubicin,6-diazo-5-oxo-L-norleucine, morpholino-doxorubicin,cyanomorpholino-doxorubicin, 2-pyrrolino-doxorubicin anddeoxydoxorubicin), epirubicin, esorubicin, idarubicin, nemorubicin,marcellomycin, mitomycins such as mitomycin C, mycophenolic acid,nogalamycin, olivomycins, peplomycin, porfiromycin, puromycin,quelamycin, rodorubicin, streptonigrin, streptozocin, tubercidin,ubenimex, zinostatin, zorubicin; anti-metabolites such as methotrexateand 5-fluorouracil (5-FU); folic acid analogs such as denopterin,methotrexate, pteropterin, trimetrexate; purine analogs such asfludarabine, 6-mercaptopurine, thiamiprine, thioguanine; pyrimidineanalogs such as ancitabine, azacitidine, 6-azauridine, carmofur,cytarabine, dideoxyuridine, doxifluridine, enocitabine, floxuridine;androgens such as calusterone, dromostanolone propionate, epitiostanol,mepitiostane, testolactone; anti-adrenals such as aminoglutethimide,mitotane, trilostane; folic acid replenisher such as frolinic acid;aceglatone; aldophosphamide glycoside; aminolevulinic acid; eniluracil;amsacrine; bestrabucil; bisantrene; edatraxate; defofamine; demecolcine;diaziquone; elformithine; elliptinium acetate; an epothilone; etoglucid;gallium nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids suchas maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol;nitraerine; pentostatin; phenamet; pirarubicin; losoxantrone;podophyllinic acid; 2-ethylhydrazide; procarbazine; PSK® polysaccharidecomplex (JHS Natural Products, Eugene, Oreg.); razoxane; rhizoxin;sizofiran; spirogermanium; tenuazonic acid; triaziquone;2,2′,2″-trichlorotriethylamine; trichothecenes (especially T-2 toxin,verracurin A, roridin A and anguidine); urethan; vindesine; dacarbazine;mannomustine; mitobronitol; mitolactol; pipobroman; gacytosine;arabinoside (“Ara-C”); cyclophosphamide; thiotepa; 6-thioguanine;mercaptopurine; methotrexate; platinum analogs such as cisplatin andcarboplatin; vinblastine; etoposide (VP-16); ifosfamide; mitoxantrone;vincristine; vinorelbine (NAVELBINE®); novantrone; teniposide;edatrexate; daunomycin; aminopterin; capecitabine (XELODA®, Roche);ibandronate; CPT-11; topoisomerase inhibitor RFS 2000;difluoromethylornithine (DMFO); retinoids such as retinoic acid; andpharmaceutically acceptable salts, acids and derivatives of any of theabove.

Also included in the definition of “chemotherapeutic agent” are: (i)anti-hormonal agents that act to regulate, or inhibit, hormone action ontumors, such as anti-estrogens and selective estrogen receptormodulators (SERMs), including, e.g., tamoxifen (including NOLVADEX®;tamoxifen citrate), raloxifene, droloxifene, 4-hydroxytamoxifen,trioxifene, keoxifene, LY117018, onapristone, and FARESTON® (toremifinecitrate); (ii) aromatase inhibitors that inhibit the enzyme aromatase,which regulates estrogen production in the adrenal glands, such as,e.g., 4 (5)-imidazoles, aminoglutethimide, MEGASE® (megestrol acetate),AROMASIN® (exemestane; Pfizer), formestanie, fadrozole, RIVISOR®(vorozole), FEMARA® (letrozole; Novartis), and ARIMIDEX® (anastrozole;AstraZeneca); (iii) anti-androgens such as flutamide, nilutamide,bicalutamide, leuprolide, and goserelin; as well as troxacitabine (a1,3-dioxolane nucleoside cytosine analog); (iv) protein kinaseinhibitors such as MEK inhibitors (WO 2007/044515); (v) lipid kinaseinhibitors; (vi) antisense oligonucleotides, particularly those whichinhibit expression of genes in signaling pathways implicated in aberrantcell proliferation, e.g., PKC-alpha, Raf and H-Ras, such as oblimersen(GENASENSE®, Genta Inc.); (vii) ribozymes such as VEGF expressioninhibitors (e.g., ANGIOZYME®) and HER2 expression inhibitors; (viii)vaccines such as gene therapy vaccines, e.g., ALLOVECTIN®, LEUVECTIN®,and VAXID®; PROLEUKIN® rIL-2; topoisomerase 1 inhibitors such asLURTOTECAN®; ABARELIX® rmRH; (ix) anti-angiogenic agents such asbevacizumab (AVASTIN®, Genentech); and pharmaceutically acceptablesalts, acids and derivatives of any of the above.

Also included in the definition of “chemotherapeutic agent” aretherapeutic antibodies such as alemtuzumab (Campath), bevacizumab(AVASTIN®, Genentech); cetuximab (ERBITUX®, Imclone); panitumumab(VECTIBIX®, Amgen), rituximab (RITUXAN®, Genentech/Biogen Idec),pertuzumab (OMNITARG™, 2C4, Genentech), trastuzumab (HERCEPTIN®,Genentech), tositumomab (Bexxar, Corixia), and the antibody drugconjugate, gemtuzumab ozogamicin (MYLOTARG®, Wyeth).

Humanized monoclonal antibodies with therapeutic potential aschemotherapeutic agents, in combination with the gamma-glutamylinhibitors of the invention include: alemtuzumab, apolizumab,aselizumab, atlizumab, bapineuzumab, bevacizumab, bivatuzumabmertansine, cantuzumab mertansine, cedelizumab, certolizumab pegol,cidfusituzumab, cidtuzumab, daclizumab, eculizumab, efalizumab,epratuzumab, erlizumab, felvizumab, fontolizumab, gemtuzumab ozogamicin,inotuzumab ozogamicin, ipilimumab, labetuzumab, lintuzumab, matuzumab,mepolizumab, motavizumab, motovizumab, natalizumab, nimotuzumab,nolovizumab, numavizumab, ocrelizumab, omalizumab, palivizumab,pascolizumab, pecfusituzumab, pectuzumab, pertuzumab, pexelizumab,ralivizumab, ranibizumab, reslivizumab, reslizumab, resyvizumab,rovelizumab, ruplizumab, sibrotuzumab, siplizumab, sontuzumab,tacatuzumab tetraxetan, tadocizumab, talizumab, tefibazumab,tocilizumab, toralizumab, trastuzumab, tucotuzumab celmoleukin,tucusituzumab, umavizumab, urtoxazumab, and visilizumab.

A “metabolite” is a product produced through metabolism in the body of aspecified compound, or salt thereof. Metabolites of a compound may beidentified using routine techniques known in the art, and theiractivities determined, using tests such as those described herein. Suchproducts may result e.g., from the oxidation, reduction, hydrolysis,amidation, deamidation, esterification, deesterification, enzymaticcleavage, and the like, of the administered compound. Accordingly, theinvention includes metabolites of compounds of the invention, includingcompounds produced by a process comprising contacting a compound of thisinvention with a mammal for a period of time sufficient to yield ametabolic product thereof.

The term “package insert” is used to refer to instructions customarilyincluded in commercial packages of therapeutic products, that containinformation about the indications, usage, dosage, administration,contraindications and/or warnings concerning the use of such therapeuticproducts.

The term “chiral” refers to molecules which have the property ofnon-superimposability of the mirror image partner, while the term“achiral” refers to molecules which are superimposable on their mirrorimage partner.

The term “stereoisomers” refers to compounds which have identicalchemical constitution, but differ with regard to the arrangement of theatoms, or groups, in space.

“Diastereomer” refers to a stereoisomer with two or more centers ofchirality and whose molecules are not mirror images of one another.Diastereomers have different physical properties, e.g., melting points,boiling points, spectral properties, and reactivities. Mixtures ofdiastereomers may separate under high resolution analytical procedures,such as electrophoresis and chromatography.

“Enantiomers” refer to two stereoisomers of a compound which arenon-superimposable mirror images of one another.

Stereochemical definitions and conventions used herein generally followS. P. Parker, Ed., McGraw-Hill Dictionary of Chemical Terms (1984)McGraw-Hill Book Company, New York; and Eliel, E. and Wilen, S.,“Stereochemistry of Organic Compounds”, John Wiley & Sons, Inc., NewYork, 1994. The compounds of the invention may contain asymmetric orchiral centers, and therefore exist in different stereoisomeric forms.It is intended that the compounds of this invention have the(L)-conformation at the carbon adjacent to the R2 group in the compoundsof Formula I and II, and the carbon adjacent to the COOH group inFormula III.

Many organic compounds exist in optically active forms, i.e., they havethe ability to rotate the plane of plane-polarized light. In describingan optically active compound, the prefixes D and L, or R and S, are usedto denote the absolute configuration of the molecule about its chiralcenter(s). For amino acids and derivatives thereof, the D and Lnomenclature has been traditionally used to designate the conformationat the chiral carbon adjacent to the carboxyl group. The prefixes d andl or (+) and (−) may be employed to designate the sign of rotation ofplane-polarized light by the compound, with (−) or l meaning that thecompound is levorotatory. A compound prefixed with (+) or d isdextrorotatory. For a given chemical structure, these stereoisomers areidentical, except that they are mirror images of one another. A specificstereoisomer may also be referred to as an enantiomer, and a mixture ofsuch isomers is often called an enantiomeric mixture. A 50:50 mixture ofenantiomers is referred to as a racemic mixture, or a racemate, whichmay occur where there has been no stereoselection, or stereospecificityin a chemical reaction or process. The terms “racemic mixture” and“racemate” refer to an equimolar mixture of two enantiomeric species,devoid of optical activity.

The phrase “pharmaceutically acceptable salt” as used herein, refers topharmaceutically acceptable organic, or inorganic, salts of a compoundof the invention. Exemplary salts include, but are not limited to,sulfate, citrate, acetate, oxalate, chloride, bromide, iodide, nitrate,bisulfate, phosphate, acid phosphate, isonicotinate, lactate,salicylate, acid citrate, tartrate, oleate, tannate, pantothenate,bitartrate, ascorbate, succinate, maleate, gentisinate, fumarate,gluconate, glucuronate, saccharate, formate, benzoate, glutamate,methanesulfonate “mesylate”, ethanesulfonate, benzenesulfonate,p-toluenesulfonate, and pamoate (i.e.,1,1′-methylene-bis(2-hydroxy-3-naphthoate)) salts. A pharmaceuticallyacceptable salt may involve the inclusion of another molecule, such asan acetate ion, a succinate ion, or other counter ion. The counter ionmay be any organic, or inorganic, moiety that stabilizes the charge onthe parent compound. Furthermore, a pharmaceutically acceptable salt mayhave more than one charged atom in its structure. Instances wheremultiple charged atoms are part of the pharmaceutically acceptable saltcan have multiple counter ions. Hence, a pharmaceutically acceptablesalt can have one or more charged atoms and/or one or more counter ion.

If the compound of the invention is a base, the desired pharmaceuticallyacceptable salt may be prepared by any suitable method available in theart, e.g., treatment of the free base with an inorganic acid, such ashydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid,methanesulfonic acid, phosphoric acid and the like, or with an organicacid, such as acetic acid, trifluoroacetic acid, maleic acid, succinicacid, mandelic acid, fumaric acid, malonic acid, pyruvic acid, oxalicacid, glycolic acid, salicylic acid, a pyranosidyl acid, such asglucuronic acid or galacturonic acid, an alpha hydroxy acid, such ascitric acid or tartaric acid, an amino acid, such as aspartic acid orglutamic acid, an aromatic acid, such as benzoic acid or cinnamic acid,a sulfonic acid, such as p-toluenesulfonic acid or ethanesulfonic acid,or the like.

If the compound of the invention is an acid, the desiredpharmaceutically acceptable salt may be prepared by any suitable method,e.g., treatment of the free acid with an inorganic or organic base, suchas an amine (primary, secondary or tertiary), an alkali metal hydroxideor alkaline earth metal hydroxide, or the like. Illustrative examples ofsuitable salts include, but are not limited to, organic salts derivedfrom amino acids, such as glycine and arginine, ammonia, primary,secondary, and tertiary amines, and cyclic amines, such as piperidine,morpholine and piperazine, and inorganic salts derived from sodium,calcium, potassium, magnesium, manganese, iron, copper, zinc, aluminumand lithium.

A “solvate” refers to an association, or complex, of one or more solventmolecules and a compound of the invention. Examples of solvents thatform solvates include, but are not limited to, water, isopropanol,ethanol, methanol, DMSO, ethylacetate, acetic acid, and ethanolamine.

Administration of Formula I Compounds

The Formula I compounds of the invention may be administered by anyroute appropriate to the condition to be treated. Suitable routesinclude intraperitoneal (IP), oral, parenteral (including subcutaneous,intramuscular, intravenous, intraarterial, intradermal, intrathecal andepidural), transdermal, rectal, nasal, topical (including buccal andsublingual), vaginal, intrapulmonary and intranasal. For localimmunosuppressive treatment, the compounds may be administered byintralesional administration, including perfusing or otherwisecontacting the graft with the inhibitor before transplantation. It willbe appreciated that the preferred route may vary with, e.g., thecondition of the recipient. Where the compound is administered orally,it may be formulated as a pill, capsule, tablet, etc., with apharmaceutically acceptable carrier or excipient. Where the compound isadministered parenterally, it may be formulated with a pharmaceuticallyacceptable parenteral vehicle, and in a unit dosage injectable form, asdetailed below.

A dose to treat human patients may range from about 10 mg to about 1000mg of Formula I compound. The dose may be from about 20 mg, 25 mg, 30mg, 40 mg, 50 mg, 60 mg, 70 mg, 75 mg, 80 mg, 90 mg, 100 mg, 150 mg, 200mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg, 600 mg, 650mg, 700 mg, 750 mg, 800 mg, 850 mg, 900 mg, 950 mg, 1000 mg of a FormulaI compound, or any dose ranging between any two of those doses. In someinstances, for example, where L cysteine or cystamine or other compoundssuitable for use as food supplements are used to obtain Formula Icompounds of this invention, the doses may also be from about about 20mg, 25 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg, 75 mg, 80 mg, 90 mg, 100mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550mg, 600 mg, 650 mg, 700 mg, 750 mg, 800 mg, 850 mg, 900 mg, 950 mg, 1000mg, 1500 mg, 2000 mg, 2500 mg, 3000 mg, 3500 mg, 4000 mg, 4500 mg, 5000mg, 5500 mg, 6000 mg, 6500 mg, 7000 mg, 7500 mg, 8000 mg, 8500 mg, 9000mg, 9500 mg, or about 10,000 mg, or any dose ranging between any two ofthose doses, for example from about 100 mg to about 10,000 mg. A typicaldose may be about 100 mg to about 600 mg tid of the compound. A dose maybe administered once a day (QID), twice per day (BID), or morefrequently, depending on the pharmacokinetic and pharmacodynamicproperties, including absorption, distribution, metabolism, andexcretion of the particular compound. In addition, toxicity factors mayinfluence the dosage and administration regimen. A typical dose whenadministered orally, the pill, capsule, or tablet may be ingested dailyor less frequently for a specified period of time. The regimen may berepeated for a number of cycles of therapy.

Methods of Treatment with Formula I Compounds

Formula I compounds of the present invention are useful for treatinghyperproliferative diseases, conditions and/or disorders including, butnot limited to, cancer. Accordingly, an aspect of this inventionincludes methods of treating, or preventing, diseases or conditions thatcan be treated or prevented by inhibiting GGC. In one embodiment, themethod comprises administering to a subject, in need thereof, atherapeutically effective amount of a compound of Formula I, or astereoisomer, enantiomer, geometric isomer, tautomer, orpharmaceutically acceptable salt thereof. In one embodiment, a humanpatient is treated with a compound of Formula I and a pharmaceuticallyacceptable carrier, adjuvant, or vehicle, wherein said compound ofFormula I is present in an amount to detectably inhibit GGC activity.

Cancers which can be treated according to the methods of this inventioninclude, but are not limited to, breast, ovary, cervix, prostate,testis, genitourinary tract, esophagus, larynx, glioblastoma,neuroblastoma, stomach, skin, keratoacanthoma, lung, epidermoidcarcinoma, large cell carcinoma, non-small cell lung carcinoma (NSCLC),small cell carcinoma, lung adenocarcinoma, bone, colon, adenoma,pancreas, adenocarcinoma, thyroid, follicular carcinoma,undifferentiated carcinoma, papillary carcinoma, seminoma, melanoma,sarcoma, bladder carcinoma, liver carcinoma and biliary passages, kidneycarcinoma, myeloid disorders, lymphoid disorders, hairy cells, buccalcavity and pharynx (oral), lip, tongue, mouth, pharynx, small intestine,colon-rectum, large intestine, rectum, brain and central nervous system,Hodgkin's and leukemia.

Formula I compounds may be useful for in vitro, in situ, and in vivodiagnosis or treatment of mammalian cells, organisms, or associatedpathological conditions, such as hyperproliferative disease and/orcancer.

Formula I compounds may be useful for treating conditions of the brainand central nervous system which require transport across theblood-brain barrier. Certain Formula I compounds have favorablepenetrant properties for delivery to the brain. Disorders of the brainwhich may be effectively treated with Formula I compounds includemetastatic and primary brain tumors, such as glioblastoma and melanoma.

Formula I compounds may be useful for treating eye cancers by localizeddelivery to the eye. Certain Formula I compounds have favorableproperties for delivery to, and uptake into, the eye. Certain Formula Icompounds may enhance efficacy and extend duration of response fortreatment of wet AMD in combination with ranibizumab (LUCENTIS®,Genentech, Inc.) and bevacizumab (AVASTIN®, Genentech, Inc.).

Another aspect of this invention provides a compound of this inventionfor use in the treatment of the diseases or conditions described hereinin a subject, e.g., a human, suffering from such disease or condition.Also provided is the use of a compound of this invention in thepreparation of a medicament for the treatment of the diseases andconditions described herein in a warm-blooded animal, such as a mammal,e.g. a human, suffering from such disorder.

Pharmaceutical Formulation/Compositions and Uses

In order to use a Formula I compound for the therapeutic treatment(including prophylactic treatment) of mammals including humans, it isnormally formulated in accordance with standard pharmaceutical practiceas a pharmaceutical composition. According to this aspect of theinvention, there is provided a pharmaceutical composition comprising acompound of this invention in association with a pharmaceuticallyacceptable diluent or carrier.

A typical formulation is prepared by mixing a Formula I compound and acarrier, diluent or excipient. Suitable carriers, diluents andexcipients are well known to those skilled in the art and includematerials such as carbohydrates, waxes, water soluble and/or swellablepolymers, hydrophilic or hydrophobic materials, gelatin, oils, solvents,water and the like. The particular carrier, diluent or excipient usedwill depend upon the means and purpose for which the compound of thepresent invention is being applied. Solvents are generally selectedbased on solvents recognized by persons skilled in the art as safe(GRAS) to be administered to a mammal. In general, safe solvents arenon-toxic aqueous solvents such as water and other non-toxic solventsthat are soluble or miscible in water. Suitable aqueous solvents includewater, ethanol, propylene glycol, polyethylene glycols (e.g., PEG 400,PEG 300), etc. and mixtures thereof. The formulations may also includeone or more buffers, stabilizing agents, surfactants, wetting agents,lubricating agents, emulsifiers, suspending agents, preservatives,antioxidants, opaquing agents, glidants, processing aids, colorants,sweeteners, perfuming agents, flavoring agents and other known additivesto provide an elegant presentation of the drug (i.e., a compound of thepresent invention or pharmaceutical composition thereof) or aid in themanufacturing of the pharmaceutical product (i.e., medicament).

The formulations may be prepared using conventional dissolution andmixing procedures. For example, the bulk drug substance (i.e., compoundof the present invention or stabilized form of the Formula I compound(e.g., complex with a cyclodextrin derivative or other knowncomplexation agent) is dissolved in a suitable solvent in the presenceof one or more of the excipients described above. The compound of thepresent invention is typically formulated into pharmaceutical dosageforms to provide an easily controllable dosage of the drug and to enablepatient compliance with the prescribed regimen.

The pharmaceutical composition (or formulation) for application may bepackaged in a variety of ways depending upon the method used foradministering the drug. Generally, an article for distribution includesa container having deposited therein the pharmaceutical formulation inan appropriate form. Suitable containers are well known to those skilledin the art and include materials such as bottles (plastic and glass),sachets, ampoules, plastic bags, metal cylinders, and the like. Thecontainer may also include a tamper-proof assemblage to preventindiscreet access to the contents of the package. In addition, thecontainer has deposited thereon a label that describes the contents ofthe container. The label may also include appropriate warnings.

Pharmaceutical formulations of the compounds of the present inventionmay be prepared for various routes and types of administration. Forexample, a compound of Formula I having the desired degree of purity mayoptionally be mixed with pharmaceutically acceptable diluents, carriers,excipients or stabilizers (Remington's Pharmaceutical Sciences (1980)16th edition, Osol, A. Ed.), in the form of a lyophilized formulation,milled powder, or an aqueous solution. Formulation may be conducted bymixing at ambient temperature at the appropriate pH, and at the desireddegree of purity, with physiologically acceptable carriers, i.e.,carriers that are non-toxic to recipients at the dosages andconcentrations employed. The pH of the formulation depends mainly on theparticular use and the concentration of compound, but may range fromabout 3 to about 8. Formulation in an acetate buffer at pH 5 is asuitable embodiment.

The compound of this invention for use herein is preferably sterile. Inparticular, formulations to be used for in vivo administration must besterile. Such sterilization is readily accomplished by filtrationthrough sterile filtration membranes.

The compound ordinarily can be stored as a solid composition, alyophilized formulation or as an aqueous solution (e.g. in saline).

The pharmaceutical compositions of the invention comprising a Formula Icompound will be formulated, dosed and administered in a fashion, i.e.,amounts, concentrations, schedules, course, vehicles and route ofadministration, consistent with good medical practice. Factors forconsideration in this context include the particular disorder beingtreated, the particular mammal being treated, the clinical condition ofthe individual patient, the cause of the disorder, the site of deliveryof the agent, the method of administration, the scheduling ofadministration, and other factors known to medical practitioners. Inaddition to the compounds and salt forms provided herein, the inventionincludes pharmaceutical compositions, including tablets, capsules,solutions, and suspensions for parenteral and oral delivery forms andformulations, comprising a pharmaceutically acceptable carrier andtherapeutically effective amounts of one or more of the GGCI compoundsherein provided. GGCI pharmaceutical compositions can include salts andhydrates.

In human and animal therapy for the treatment of cancer, for example inthe treatment of cancer and other related disorders, diseases andconditions noted herein, the compounds and their crystal forms describedand provided herein, their pharmaceutically acceptable salts, andpharmaceutically acceptable solvates of either entity, can beadministered alone, but will generally be administered in admixture witha pharmaceutical carrier selected with regard to the intended route ofadministration and standard pharmaceutical practice. Preferably, theyare administered orally in the form of tablets containingpharmaceutically acceptable excipients, such as starch or lactose, or incapsules or ovules either alone or in admixture with excipients, or inthe form of elixirs, solutions or suspensions containing flavouring orcolouring agents. They can also be injected parenterally, for example,intravenously, intramuscularly or subcutaneously. For parenteraladministration, they are best used in the form of a sterile aqueoussolution which may contain other substances, for example enough salts ormonosaccharides to make the solution isotonic with blood. For buccal orsublingual administration they may be administered in the form oftablets or lozenges which can be formulated in a conventional manner.

As a general proposition, the initial pharmaceutically effective amountof the Formula I compound administered parenterally per dose will be inthe range of about 0.01-100 mg/kg, 0.01-1.0, 1.0 to 10.0, or 10.0 to100.0 mg/kg. The amount of the Formula I compound administeredparenterally per dose may also be about 0.1 to 20 mg/kg of patient bodyweight per day, with the typical initial range of compound used being0.3 to 15 mg/kg/day.

Acceptable diluents, carriers, excipients and stabilizers are nontoxicto recipients at the dosages and concentrations employed, and includesaline and/or buffers such as phosphate, citrate and other organicacids; antioxidants including ascorbic acid and methionine;preservatives (such as octadecyldimethylbenzyl ammonium chloride;hexamethonium chloride; benzalkonium chloride, benzethonium chloride;phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propylparaben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol);low molecular weight (less than about 10 residues) polypeptides;proteins, such as serum albumin, gelatin, or immunoglobulins;hydrophilic polymers such as polyvinylpyrrolidone; amino acids such asglycine, glutamine, asparagine, histidine, arginine, or lysine;monosaccharides, disaccharides and other carbohydrates includingglucose, mannose, or dextrins; chelating agents such as EDTA; sugarssuch as sucrose, mannitol, trehalose or sorbitol; salt-formingcounter-ions such as sodium; metal complexes (e.g., Zn-proteincomplexes); and/or non-ionic surfactants such as TWEEN™, PLURONICS™ orpolyethylene glycol (PEG). The active pharmaceutical ingredients mayalso be entrapped in microcapsules prepared, e.g., by coacervationtechniques or by interfacial polymerization, e.g.,hydroxymethylcellulose or gelatin-microcapsules andpoly-(methylmethacylate) microcapsules, respectively, in colloidal drugdelivery systems (e.g., liposomes, albumin microspheres, microemulsions,nano-particles and nanocapsules) or in macroemulsions. Such techniquesare disclosed in Remington's Pharmaceutical Sciences 16th edition, Osol,A. Ed. (1980).

Sustained-release preparations of Formula I compounds may be prepared.Suitable examples of sustained-release preparations includesemipermeable matrices of solid hydrophobic polymers containing acompound of Formula I, which matrices are in the form of shapedarticles, e.g., films, or microcapsules. Examples of sustained-releasematrices include polyesters, hydrogels (e.g.,poly(2-hydroxyethyl-methacrylate), or poly(vinyl alcohol)), polylactides(U.S. Pat. No. 3,773,919), copolymers of L-glutamic acid andgamma-ethyl-L-glutamate, non-degradable ethylene-vinyl acetate,degradable lactic acid-glycolic acid copolymers such as the LUPRONDEPOT™ (injectable microspheres composed of lactic acid-glycolic acidcopolymer and leuprolide acetate) and poly-D-(−)-3-hydroxybutyric acid.

The formulations include those suitable for the administration routesdetailed herein. The formulations may conveniently be presented in unitdosage form and may be prepared by any of the methods well known in theart of pharmacy. Techniques and formulations generally are found inRemington's Pharmaceutical Sciences (Mack Publishing Co., Easton, Pa.).Such methods include the step of bringing into association the activeingredient with the carrier which constitutes one or more accessoryingredients. In general the formulations are prepared by uniformly andintimately bringing into association the active ingredient with liquidcarriers or finely divided solid carriers or both, and then, ifnecessary, shaping the product.

Formulations of a compound of Formula I suitable for oral administrationmay be prepared as discrete units such as pills, capsules, cachets ortablets each containing a predetermined amount of a compound of FormulaI.

Compressed tablets may be prepared by compressing in a suitable machinethe active ingredient in a free-flowing form such as a powder orgranules, optionally mixed with a binder, lubricant, inert diluent,preservative, surface active or dispersing agent. Molded tablets may bemade by molding in a suitable machine a mixture of the powdered activeingredient moistened with an inert liquid diluent. The tablets mayoptionally be coated or scored and optionally are formulated so as toprovide slow or controlled release of the active ingredient therefrom.

Tablets, troches, lozenges, aqueous or oil suspensions, dispersiblepowders or granules, emulsions, hard or soft capsules, e.g., gelatincapsules, syrups or elixirs may be prepared for oral use. Formulationsof compounds of Formula I intended for oral use may be preparedaccording to any method known to the art for the manufacture ofpharmaceutical compositions and such compositions may contain one ormore agents including sweetening agents, flavoring agents, coloringagents and preserving agents, in order to provide a palatablepreparation. Tablets containing the active ingredient in admixture withnon-toxic pharmaceutically acceptable excipient which are suitable formanufacture of tablets are acceptable. These excipients may be, e.g.,inert diluents, such as calcium or sodium carbonate, lactose, calcium orsodium phosphate; granulating and disintegrating agents, such as maizestarch, or alginic acid; binding agents, such as starch, gelatin oracacia; and lubricating agents, such as magnesium stearate, stearic acidor talc. Tablets may be uncoated or may be coated by known techniquesincluding microencapsulation to delay disintegration and adsorption inthe gastrointestinal tract and thereby provide a sustained action over alonger period. For example, a time delay material such as glycerylmonostearate or glyceryl distearate alone or with a wax may be employed.

For treatment of the eye or other external tissues, e.g., mouth andskin, the formulations may be applied as a topical ointment or creamcontaining the active ingredient(s) in an amount of, e.g., 0.075 to 20%w/w. When formulated in an ointment, the active ingredients may beemployed with either a paraffinic or a water-miscible ointment base.Alternatively, the active ingredients may be formulated in a cream withan oil-in-water cream base.

If desired, the aqueous phase of the cream base may include a polyhydricalcohol, i.e., an alcohol having two or more hydroxyl groups such aspropylene glycol, butane 1,3-diol, mannitol, sorbitol, glycerol andpolyethylene glycol (including PEG 400) and mixtures thereof. Thetopical formulations may desirably include a compound which enhancesabsorption or penetration of the active ingredient through the skin orother affected areas. Examples of such dermal penetration enhancersinclude dimethyl sulfoxide and related analogs.

The oily phase of the emulsions of this invention may be constitutedfrom known ingredients in a known manner. While the phase may comprisemerely an emulsifier, it desirably comprises a mixture of at least oneemulsifier with a fat or an oil or with both a fat and an oil.Preferably, a hydrophilic emulsifier is included together with alipophilic emulsifier which acts as a stabilizer. It is also preferredto include both an oil and a fat. Together, the emulsifier(s) with orwithout stabilizer(s) make up the so-called emulsifying wax, and the waxtogether with the oil and fat make up the so-called emulsifying ointmentbase which forms the oily dispersed phase of the cream formulations.Emulsifiers and emulsion stabilizers suitable for use in the formulationof the invention include Tween® 60, Span® 80, cetostearyl alcohol,benzyl alcohol, myristyl alcohol, glyceryl mono-stearate and sodiumlauryl sulfate.

Aqueous suspensions of Formula I compounds contain the active materialsin admixture with excipients suitable for the manufacture of aqueoussuspensions. Such excipients include a suspending agent, such as sodiumcarboxymethylcellulose, croscarmellose, povidone, methylcellulose,hydroxypropyl methylcellulose, sodium alginate, polyvinylpyrrolidone,gum tragacanth and gum acacia, and dispersing or wetting agents such asa naturally occurring phosphatide (e.g., lecithin), a condensationproduct of an alkylene oxide with a fatty acid (e.g., polyoxyethylenestearate), a condensation product of ethylene oxide with a long chainaliphatic alcohol (e.g., heptadecaethyleneoxycetanol), a condensationproduct of ethylene oxide with a partial ester derived from a fatty acidand a hexitol anhydride (e.g., polyoxyethylene sorbitan monooleate). Theaqueous suspension may also contain one or more preservatives such asethyl or n-propyl p-hydroxybenzoate, one or more coloring agents, one ormore flavoring agents and one or more sweetening agents, such as sucroseor saccharin.

The pharmaceutical compositions of compounds of Formula I may be in theform of a sterile injectable preparation, such as a sterile injectableaqueous or oleaginous suspension. This suspension may be formulatedaccording to the known art using those suitable dispersing or wettingagents and suspending agents which have been mentioned above. Thesterile injectable preparation may also be a sterile injectable solutionor suspension in a non-toxic parenterally acceptable diluent or solvent,such as a solution in 1,3-butanediol prepared as a lyophilized powder.Among the acceptable vehicles and solvents that may be employed arewater, Ringer's solution and isotonic sodium chloride solution. Inaddition, sterile fixed oils may conventionally be employed as a solventor suspending medium. For this purpose any bland fixed oil may beemployed including synthetic mono- or diglycerides. In addition, fattyacids such as oleic acid may likewise be used in the preparation ofinjectables.

The amount of active ingredient that may be combined with the carriermaterial to produce a single dosage form will vary depending upon thehost treated and the particular mode of administration. For example, atime-release formulation intended for oral administration to humans maycontain approximately 1 to 1000 mg of active material compounded with anappropriate and convenient amount of carrier material which may varyfrom about 5 to about 95% of the total compositions (weight:weight). Thepharmaceutical composition can be prepared to provide easily measurableamounts for administration. For example, an aqueous solution intendedfor intravenous infusion may contain from about 3 to 500 μg of theactive ingredient per milliliter of solution in order that infusion of asuitable volume at a rate of about 30 mL/hr can occur.

Formulations suitable for parenteral administration include aqueous andnon-aqueous sterile injection solutions which may contain anti-oxidants,buffers, bacteriostats and solutes which render the formulation isotonicwith the blood of the intended recipient; and aqueous and non-aqueoussterile suspensions which may include suspending agents and thickeningagents.

Formulations suitable for topical administration to the eye also includeeye drops wherein the active ingredient is dissolved or suspended in asuitable carrier, especially an aqueous solvent for the activeingredient. The active ingredient is preferably present in suchformulations in a concentration of about 0.5 to 20% w/w, about 0.5 to10% w/w, or about 1.5% w/w.

Formulations suitable for topical administration in the mouth includelozenges comprising the active ingredient in a flavored basis, usuallysucrose and acacia or tragacanth; pastilles comprising the activeingredient in an inert basis such as gelatin and glycerin, or sucroseand acacia; and mouthwashes comprising the active ingredient in asuitable liquid carrier.

Formulations for rectal administration may be presented as a suppositorywith a suitable base comprising, e.g. cocoa butter or a salicylate.

Formulations suitable for intrapulmonary or nasal administration have aparticle size e.g. in the range of 0.1 to 500 microns (includingparticle sizes in a range between 0.1 and 500 microns in incrementsmicrons such as 0.5, 1, 30 microns, 35 microns, etc.) which isadministered by rapid inhalation through the nasal passage or byinhalation through the mouth so as to reach the alveolar sacs. Suitableformulations include aqueous or oily solutions of the active ingredient.Formulations suitable for aerosol or dry powder administration may beprepared according to conventional methods and may be delivered withother therapeutic agents such as compounds heretofore used in thetreatment or prophylaxis disorders as described below.

Formulations suitable for vaginal administration may be presented aspessaries, tampons, creams, gels, pastes, foams or spray formulationscontaining in addition to the active ingredient such carriers as areknown in the art to be appropriate.

The formulations may be packaged in unit-dose or multi-dose containers,e.g. sealed ampoules and vials, and may be stored in a freeze-dried(lyophilized) condition requiring only the addition of the sterileliquid carrier, e.g., water, for injection immediately prior to use.Extemporaneous injection solutions and suspensions are prepared fromsterile powders, granules and tablets of the kind previously described.Preferred unit dosage formulations are those containing a daily dose orunit daily sub-dose, as herein above recited, or an appropriate fractionthereof, of the active ingredient.

The invention further provides veterinary compositions comprising atleast one active ingredient as above defined together with a veterinarycarrier therefore. Veterinary carriers are materials useful for thepurpose of administering the composition and may be solid, liquid orgaseous materials which are otherwise inert or acceptable in theveterinary art and are compatible with the active ingredient. Theseveterinary compositions may be administered parenterally, orally or byany other desired route.

Combination Therapy

The compounds of Formula I may be employed alone, or in combination withother therapeutic agents, for the treatment of a disease or disorderdescribed herein, such as a hyperproliferative disorder (e.g., cancer).In certain embodiments, a compound of Formula I is combined in apharmaceutical combination formulation, or dosing regimen as combinationtherapy, with a second compound that has anti-hyperproliferativeproperties or that is useful for treating a hyperproliferative disorder(e.g., cancer). The second compound of the pharmaceutical combinationformulation or dosing regimen preferably has complementary activities tothe compound of Formula I such that they do not adversely affect eachother. Such compounds are suitably present in combination in amountsthat are effective for the purpose intended. In one embodiment, acomposition of this invention comprises a compound of Formula I, incombination with a chemotherapeutic agent such as described herein.

The combination therapy may be administered as a simultaneous orsequential regimen. When administered sequentially, the combination maybe administered in two or more administrations. The combinedadministration includes coadministration, using separate formulations ora single pharmaceutical formulation, and consecutive administration ineither order, wherein preferably there is a time period while both (orall) active agents simultaneously exert their biological activities.

Suitable dosages for any of the above coadministered agents are thosepresently used and may be lowered due to the combined action (synergy)of the newly identified agent and other chemotherapeutic agents ortreatments.

The combination therapy may provide “synergy” and prove “synergistic”,i.e., the effect achieved when the active ingredients used together isgreater than the sum of the effects that results from using thecompounds separately. A synergistic effect may be attained when theactive ingredients are: (1) co-formulated and administered or deliveredsimultaneously in a combined, unit dosage formulation; (2) delivered byalternation or in parallel as separate formulations; or (3) by someother regimen. When delivered in alternation therapy, a synergisticeffect may be attained when the compounds are administered or deliveredsequentially, e.g., by different injections in separate syringes,separate pills or capsules, or separate infusions. In general, duringalternation therapy, an effective dosage of each active ingredient isadministered sequentially, i.e., serially, whereas in combinationtherapy, effective dosages of two or more active ingredients areadministered together.

In a particular embodiment of anti-cancer therapy, a compound of FormulaI, or a stereoisomer, geometric isomer, tautomer, solvate, metabolite,or pharmaceutically acceptable salt or prodrug thereof, may be combinedwith other chemotherapeutic, hormonal or antibody agents such as thosedescribed herein, as well as combined with surgical therapy andradiotherapy. Combination therapies according to the present inventionthus comprise the administration of at least one compound of Formula I,or a stereoisomer, geometric isomer, tautomer, solvate, metabolite, orpharmaceutically acceptable salt or prodrug thereof, and the use of atleast one other cancer treatment method. The amounts of the compound(s)of Formula I and the other pharmaceutically active chemotherapeuticagent(s) and the relative timings of administration will be selected inorder to achieve the desired combined therapeutic effect.

Metabolites of Formula I Compounds

Also falling within the scope of this invention are the in vivometabolic products of Formula I described herein. Such products mayresult, e.g., from the condensation, oxidation, reduction, hydrolysis,amidation, deamidation, esterification, deesterification, enzymaticcleavage, and the like, of the administered compound. Accordingly, theinvention includes metabolites of compounds of Formula I, includingcompounds produced by a process comprising contacting a compound of thisinvention with a mammal for a period of time sufficient to yield ametabolic product thereof.

Metabolite products typically are identified by preparing aradiolabelled (e.g., 14C or 3H) isotope of a compound of the invention,administering it parenterally in a detectable dose (e.g., greater thanabout 0.5 mg/kg) to an animal such as rat, mouse, guinea pig, monkey, orto man, allowing sufficient time for metabolism to occur (typicallyabout 30 seconds to 30 hours) and isolating its conversion products fromthe urine, blood or other biological samples. These products are easilyisolated since they are labeled (others are isolated by the use ofantibodies capable of binding epitopes surviving in the metabolite). Themetabolite structures are determined in conventional fashion, e.g., byMS, LC/MS or NMR analysis. In general, analysis of metabolites is donein the same way as conventional drug metabolism studies well known tothose skilled in the art. The metabolite products, so long as they arenot otherwise found in vivo, may be useful in diagnostic assays fortherapeutic dosing of the compounds of the invention.

Articles of Manufacture/Kits

In another embodiment of the invention, an article of manufacture, or“kit”, containing materials useful for the treatment of the diseases anddisorders described above is provided. The kit comprises a containercomprising a compound of Formula I. The kit may further comprise a labelor package insert, on or associated with the container. The term“package insert” is used to refer to instructions customarily includedin commercial packages of therapeutic products, that contain informationabout the indications, usage, dosage, administration, contraindicationsand/or warnings concerning the use of such therapeutic products.Suitable containers include, e.g., bottles, vials, syringes, blisterpack, etc. The container may be formed from a variety of materials suchas glass or plastic. The container may hold a compound of Formula I or aformulation thereof which is effective for treating the condition andmay have a sterile access port (e.g., the container may be anintravenous solution bag or a vial having a stopper pierceable by ahypodermic injection needle). At least one active agent in thecomposition is a compound of Formula I. The label or package insertindicates that the composition is used for treating the condition ofchoice, such as cancer. In addition, the label or package insert mayindicate that the patient to be treated is one having a disorder such asa hyperproliferative disorder. In one embodiment, the label or packageinserts indicates that the composition comprising a compound of FormulaI can be used to treat a disorder resulting from abnormal cell growth.The label or package insert may also indicate that the composition canbe used to treat other disorders. Alternatively, or additionally, thearticle of manufacture may further comprise a second containercomprising a pharmaceutically acceptable buffer, such as bacteriostaticwater for injection (BWFI), phosphate-buffered saline, Ringer's solutionand dextrose solution. It may further include other materials desirablefrom a commercial and user standpoint, including other buffers,diluents, filters, needles, and syringes.

The kit may further comprise directions for the administration of thecompound of Formula I and, if present, the second pharmaceuticalformulation. For example, if the kit comprises a first compositioncomprising a compound of Formula I, and a second pharmaceuticalformulation, the kit may further comprise directions for thesimultaneous, sequential or separate administration of the first andsecond pharmaceutical compositions to a patient in need thereof.

In another embodiment, the kits are suitable for the delivery of solidoral forms of a compound of Formula I, such as tablets or capsules. Sucha kit preferably includes a number of unit dosages. Such kits caninclude a card having the dosages oriented in the order of theirintended use. An example of such a kit is a “blister pack”. Blisterpacks are well known in the packaging industry and are widely used forpackaging pharmaceutical unit dosage forms. If desired, a memory aid canbe provided, e.g. in the form of numbers, letters, or other markings orwith a calendar insert, designating the days in the treatment schedulein which the dosages can be administered.

According to one embodiment, a kit may comprise (a) a first containerwith a compound of Formula I contained therein; and optionally (b) asecond container with a second pharmaceutical formulation containedtherein, wherein the second pharmaceutical formulation comprises asecond compound with anti-hyperproliferative activity. Alternatively, oradditionally, the kit may further comprise a third container comprisinga pharmaceutically-acceptable buffer, such as bacteriostatic water forinjection (BWFI), phosphate-buffered saline, Ringer's solution anddextrose solution. It may further include other materials desirable froma commercial and user standpoint, including other buffers, diluents,filters, needles, and syringes.

In certain other embodiments wherein the kit comprises a composition ofFormula I and a second therapeutic agent, the kit may comprise acontainer for containing the separate compositions such as a dividedbottle or a divided foil packet, however, the separate compositions mayalso be contained within a single, undivided container. Typically, thekit comprises directions for the administration of the separatecomponents. The kit form is particularly advantageous when the separatecomponents are preferably administered in different dosage forms (e.g.,oral and parenteral), are administered at different dosage intervals, orwhen titration of the individual components of the combination isdesired by the prescribing physician.

The invention includes an article of manufacture comprising packagingmaterial containing one or more dosage forms containing a GGCI compoundprovided herein, wherein the packaging material has a label thatindicates that the dosage form can be used for a subject having orsuspected of having or predisposed to any of the diseases, disordersand/or conditions described or referenced herein. Such dosage formsinclude, for example, tablets, capsules, solutions and suspensions forparenteral and oral delivery forms and formulations.

In yet another aspect of this invention is a kit comprising (a) at leastone GGCI compound, or salt or crystal thereof, and a pharmaceuticallyacceptable carrier, excipient and/or additive in a unit dosage form, and(b) means for containing the unit form. Since the present invention hasan aspect that relates to the treatment of the disease/conditionsdescribed herein with a combination of active ingredients, the inventionalso relates to combining separate pharmaceutical compositions in kitform. A kit may contain a pharmaceutical composition comprising GGCIcompound, or salt or crystal thereof, as provided herein, either aloneor together with a second compound as described herein.

In another specific embodiment of the invention, a dispenser designed todispense the daily doses one at a time in the order of their intendeduse is provided. Preferably, the dispenser is equipped with amemory-aid, so as to further facilitate compliance with the regimen. Anexample of such a memory-aid is a mechanical counter which indicates thenumber of daily doses that has been dispensed. Another example of such amemory-aid is a battery-powered micro-chip memory coupled with a liquidcrystal readout, or audible reminder signal which, for example, readsout the date that the last daily dose has been taken and/or reminds onewhen the next dose is to be taken.

GGCI Agents

By following the procedures and synthetic schemes described in theDetailed Description of the Invention and the Examples and using methodsand synthetic procedures known to those of skilled in the art, the saltsand compositions of the present invention may be made.

The present methods also provide certain compounds that have utility,for example, as intermediates for synthesis of GGCI. Intermediates maybe independently isolated and purified and/or crystallized, includingduring, and as a part of, the methods of synthesis provided herein.Isolated and purified and/or crystallized intermediates may also bestored for later use.

The steps and routes of synthesis are effective for preparation of avariety of GGCI salts.

Organic acids include both aliphatic and aromatic carboxylic acids andinclude, for example, aliphatic monocarboxylic acids, aliphaticdicarboxylic acids, aliphatic tricarboxylic acids, aromaticmonocarboxylic acids, aromatic dicarboxylic acids, aromatictricarboxylic acids and other organic acids known to those of skill inthe art.

Aliphatic carboxylic acids may be saturated or unsaturated. Suitablealiphatic carboxylic acids include those having from 2 to about 10carbon atoms.

Aliphatic monocarboxylic acids include saturated aliphaticmonocarboxylic acids and unsaturated aliphatic monocarboxylic acids.Examples of saturated monocarboxylic acids include acetic acid,propronic acid, butyric acid, valeric acid, caproic acid, enanthic acid,caprylic acid, pelargonic acid, and caprynic acid. Examples ofunsaturated aliphatic monocarboxylic acids include acrylic acid,propiolic acid, methacrylic acid, crotonic acid and isocrotonic acid.

Aliphatic dicarboxylic acids include saturated aliphatic dicarboxylicacids and unsaturated aliphatic dicarboxylic acids. Examples ofsaturated aliphatic dicarboxylic acids include oxalic acid, malonicacid, succinic acid, glutaric acid, adipic acid, pimelic acid, subericacid, azelaic acid, and sebacic acid. Examples of unsaturated aliphaticdicarboxylic acids include maleic acid, fumaric acid, citraconic acid,mesaconic acid, itaconic acid and the like.

In certain aspects, crystalline GGCI and salts thereof are described.These include crystalline GGCI maleate, GGCI fumarate, and GGCIsuccinate. Different GGCI crystals include those comprising thegeometric structures, unit cell structures, and structural coordinates.

Also described are GGCI salts of high purity, methods for theirpreparation, and dosage forms including GGCI salts.

The pharmaceutical compositions may include, for example, one or morepharmaceutically acceptable excipients, carriers, and/or additivessuitable for oral or parenteral administration.

The product formed by the described processes is substantially pure,that is, substantially free from any other compounds. Preferably, itcontains less than 10% impurities, and more preferably, less than about5% impurities, and even more preferably, less than about 1% impurities.The product thus formed is also preferably substantially pure, i.e.,contains less than 10% impurity, more preferably less than 5% impurity,and still more preferably less than 1% impurity. The present inventionalso includes a substantially pure anhydrous crystalline form of GGCIdisuccinate. The term “substantially pure” means that a sample of therelevant anhydrous crystalline form of GGCI disuccinate contains morethan 90% of a single polymorphic form, preferably more than 95% of asingle polymorphic form, and still more preferably more than 99% of asingle polymorphic form.

The synthetic methods described herein are also illustrated withreference to the figures, including accompanying FIG. 1. FIG. 1 shows asummary of an exemplary reaction scheme for the preparation of GGCI,which may include a GGCI salt.

Doses

A therapeutically effective amount of the compounds herein and theirpharmaceutically acceptable salts and solvates, may be from about 1mg/kg to about 10 g/kg. Other therapeutically effective dose rangesinclude, for example, from about 1.5 mg/kg to about 950 mg/kg, about 2mg/kg to about 90 mg/kg, about 3 mg/kg to about 85 mg/kg, about 4 mg/kgto about 80 mg/kg, about 5 mg/kg to about 750 mg/kg, about 5 mg/kg toabout 700 mg/kg, about 5 mg/kg to about 600 mg/kg, about 5 mg/kg toabout 500 mg/kg, about 10 mg/kg to about 400 mg/kg, about 10 mg/kg toabout 300 mg/kg, about 10 mg/kg to about 200 mg/kg, about 10 mg/kg toabout 250 mg/kg, about 10 mg/kg to about 200 mg/kg, about 10 mg/kg toabout 200 mg/kg, about 10 mg/kg to about 150 mg/kg, about 10 mg/kg toabout 100 mg/kg, about 10 mg/kg to about 75 mg/kg, about 10 mg/kg toabout 50 mg/kg, about 15 mg/kg to about 35 mg/kg, about 15 mg/kg toabout 9500 mg/kg, about 20 mg/kg to about 900 mg/kg, about 30 mg/kg toabout 850 mg/kg, about 40 mg/kg to about 800 mg/kg, about 50 mg/kg toabout 7500 mg/kg, about 50 mg/kg to about 7000 mg/kg, about 50 mg/kg toabout 600 mg/kg, about 5 mg/kg to about 500 mg/kg, about 100 mg/kg toabout 4000 mg/kg, about 100 mg/kg to about 3000 mg/kg, about 100 mg/kgto about 2000 mg/kg, about 100 mg/kg to about 2500 mg/kg, about 100mg/kg to about 2000 mg/kg, about 100 mg/kg to about 2000 mg/kg, about100 mg/kg to about 1500 mg/kg, about 100 mg/kg to about 1000 mg/kg,about 100 mg/kg to about 750 mg/kg, about 100 mg/kg to about 500 mg/kg,about 150 mg/kg to about 350 mg/kg,

In certain embodiments, the dose ranges include, for example, 1/10 ofLD50 based on toxicity data, including for example, about 50 mg/kg toabout 600 mg/kg, about 60 to about 500 mg/kg, about 70 to about 400mg/kg, about 80 to about 300 mg/kg, about 90 to about 150 mg/kg, about90 to about 120 mg/kg, about 95 to about 105 mg/kg, and about 100 mg/kg.

A daily dosage level of the compounds herein, and their pharmaceuticallyacceptable salts and solvates, may be from about 10 mg to about 6 g perday, or up to about 60 g per day (in single or divided doses). Othertherapeutically effective dose ranges include, for example, from about20 mg to about 5.9 g, from about 30 mg to about 4.7 g, from about 40 mgto about 3.5 g, from about 50 mg to about 3 g, from about 60 mg to about2.8 g, from about 70 mg to about 2.5 g, about 80 mg to about 2.3 g,about 100 mg to about 2 g, about 100 mg to about 1.5 g, about 200 mg toabout 1400 mg, about 200 mg to about 1300 mg, about 200 mg to about 1200mg, about 200 mg to about 1100 mg, about 200 mg to about 1000 mg, about300 mg to about 900 mg, about 300 mg to about 800, about 300 mg to about700 mg, about 300 mg to about 600 mg, from about 200 mg to about 59 g,from about 300 mg to about 47 g, from about 400 mg to about 35 g, fromabout 500 mg to about 30 g, from about 600 mg to about 28 g, from about700 mg to about 25 g, about 800 mg to about 23 g, about 1000 mg to about20 g, about 1000 mg to about 15 g, about 2000 mg to about 14000 mg,about 2000 mg to about 13000 mg, about 2000 mg to about 12000 mg, about2000 mg to about 11000 mg, about 2000 mg to about 10000 mg, about 3000mg to about 9000 mg, about 3000 mg to about 8000 mg, about 3000 mg toabout 7000 mg or about 3000 mg to about 6000 mg per day.

Compounds described herein, and their pharmaceutically acceptable saltsand solvates, will also be effective at doses in the order of 1/10,1/50, 1/100, 1/200, 1/300, 1/400, 1/500 and even 1/1000 of thosedescribed herein.

In some embodiments of the invention, a therapeutically effective amountis the amount effective to elicit a plasma concentration of thecompounds provided herein, and their pharmaceutically acceptable saltsand solvates, from about 0.01 mg/L to about 20 mg/L, about 0.01 mg/L toabout 15 mg/L, about 0.1 mg/L to about 10 mg/L, about 0.5 mg/L to about9 mg/L, about 1 mg/L to about 8 mg/L, about 2 mg/L to about 7 mg/L orabout 3 mg/L to about 6 mg/L.

The doses described herein, may be administered in a single dose ormultiple doses. For example, doses may be administered once, twice,three, four or more times a day, or one, two, three, four, five, or sixtimes per week.

The physician will determine the actual dosage which will be mostsuitable for an individual patient, and it will vary with the age,weight and response of the particular patient. The above dosages areexemplary of the average case; there can, of course, be individualinstances where higher or lower dosage ranges are merited, and such arewithin the scope of this invention.

Generally, in humans, IP administration of the compounds of theinvention is the preferred route. A preferred oral dosing regimen incancer treatment for a typical man is from about 400 mg to about 6000 mgper day of compound when required. Preventative doses are lower,typically from about 1/10 to about 1/20 of the above amounts, includingfrom about 20-40 mg to about 40-600 mg per day.

For veterinary use, a compound provided herein, or a veterinarilyacceptable salt thereof, or a veterinarily acceptable solvate of eitherentity, is administered as a suitably acceptable formulation.

Thus the invention provides a pharmaceutical composition comprising aGGCI compound provided herein, or a pharmaceutically acceptable saltthereof, or a pharmaceutically acceptable solvate of either entity,together with a pharmaceutically acceptable diluent or carrier.

It further provides a veterinary formulation comprising a GGCI compoundprovided herein, or a veterinarily acceptable salt thereof, or aveterinarily acceptable solvate of either entity, together with aveterinarily acceptable diluent or carrier.

The invention also provides a GGCI compound provided herein, or apharmaceutically acceptable salt thereof, or a pharmaceuticallyacceptable solvate of either entity, or a pharmaceutical compositioncontaining any of the foregoing, for use as a human medicament.

In addition, it provides a GGCI compound provided herein, or aveterinarily acceptable salt thereof, or a veterinarily acceptablesolvate of either entity, or a veterinary formulation containing any ofthe foregoing, for use as an animal medicament.

In yet another aspect, the invention provides the use of a GGCI compoundprovided herein, or a pharmaceutically acceptable salt thereof, or apharmaceutically acceptable solvate of either entity, for themanufacture of a human medicament for the curative or prophylactictreatment of a medical condition for which a GGCI is indicated.

It also provides the use of a GGCI compound provided herein, or aveterinarily acceptable salt thereof, or a veterinarily acceptablesolvate of either entity, for the manufacture of an animal medicamentfor the curative or prophylactic treatment of a medical condition forwhich a GGCI is indicated.

Moreover, the invention includes use of the compounds and compositionsprovided herein for methods for treating and/or preventing, in whole orin part, various diseases, disorders and conditions, including but notlimited to hyperproliferative disease such as cancer.

The invention also includes pharmaceutical compositions, includingtablets and capsules and other oral delivery forms and formulations,comprising a pharmaceutically acceptable carrier and therapeuticallyeffective amounts of a GGCI compound as provided herein.

The invention includes methods for the use of therapeutically effectiveamounts of a GGCI compound provided herein in the manufacture of amedicament. Such medicaments include, for example, tablets, capsules,solutions and suspensions for parenteral and oral delivery forms andformulations. Such medicaments include those for the treatment of asubject as disclosed herein.

The compounds of the invention, particularly GGCI salts, and hydrates,for example, in the disclosed crystal form, may also be prepared withanother anti-cancer agent.

Doses for such GGCI compounds, salts and/or solvates as provided hereinare envisaged to be administered in a therapeutically effective amount,for example, to inhibit cancer, delay tumor progression, and/or toreduce multidrug resistance in a subject.

The invention includes a formulation comprising a GGCI compound providedherein in amounts effective to reduce glutathione transport in the bodyof a subject. Such formulations include, for example, tablets, capsules,solutions and suspensions for parenteral and oral delivery forms andformulations.

General Aspects of Gamma-Glutamyl Cycle

The GGC biochemical cycle exists in most living cells. It enables thetransfer of amino acids, transferrin, Iron, and other moieties fromoutside a living cell through the cell membrane into the cytoplasm. Somesuch amino acids are essential for the de novo biosynthesis ofglutathione. This is one of a few mechanisms that enable the transportof amino acid into living cells, but the only mechanism that isindispensable for the biosynthesis of glutathione and which does notutilize insulin as a cofactor for the transport mechanism.

Since the multiplication rate of cancerous cells is substantially higherthan that of the non-cancerous cells of origin, by interfering with thiscycle one can suppress cancer cell growth and maintenance. This can beachieved by presenting a competitive inhibitor such as “falsemetabolite” or analog of a substrate of an enzyme in the gamma-glutamylcycle. By doing so, more damage can be introduced into the cancerouscells than to the non-cancerous cells. Moreover, a higher activity ofthe enzyme gamma-glutamyl transpeptidase was reported for cancerouscells. In order to suppress the gamma-glutamyl cycle, novel GGCIinhibitors, as disclosed herein, were developed that can compete with5-oxoproline for binding to 5-oxoprolinase and thus can block thegamma-glutamyl cycle. Blocking the GGC decreases or interferes with theinflux of amino acids into the cell, thus interfering with cell divisionand the synthesis of glutathione. Because cancerous cells needsubstantially more amino acids due to a much faster doubling time, thisresults in preferential and/or optimal damage to the cancerous cells.

Gamma-glutamyltransferase (GGT) is a key enzyme involved in glutathionemetabolism, whose expression is often significantly increased in humanmalignancies. In the past several years, several studies focused on thepossible role of GGT in tumor progression, invasion and drug resistance.The involvement of a pro-oxidant activity of GGT, besides its earlyrecognized contributions to cellular antioxidant defenses, has beenreported. GGT-derived pro-oxidants can modulate importantredox-sensitive processes and functions of the cell, with particularreference to its proliferative/apoptotic balance, which has obvious andimportant implications in tumor progression and drug resistance. Inaddition, the specificity of the enzymatic reaction carried out by GGTsuggests that suitable pro-drugs could be selectively metabolized(activated) by GGT expressed in tumor tissue. Accordingly, the compoundsof the invention may be useful in the treatment of hyperproliferativedisorders such as cancer. The compounds may inhibit tumor growth inmammals, and may be useful for treating human cancer patients.

GGT therefore plays a role as a diagnostic/prognostic marker, as well asa target for anticancer treatments.

Gamma-glutamyltransferase (GGT) is an enzyme involved in the metabolismof glutathione (gamma-glutamyl-cysteinyl-glycine; GSH), and is expressedby a wide number of cell types. GGT catalyzes the transfer of theglutamyl moiety, linked through the glutamate gamma-carboxylic acid tocysteine, to acceptor molecules including peptides, amino acids andwater.

High GGT activities are present on the luminal surface of secretory andabsorptive cells, including those of bile ducts, bile canaliculi andproximal tubules of the kidney, and in endothelial cells of nervoussystem capillaries. A dysregulated expression of GGT has been detectedin various tumor types, and GGT can be associated with GSH-dependentdrug-resistance mechanisms.

Being located on the outer aspect of the cell membrane, GGT catalyzesthe degradation of extracellular GSH, thus favouring the recovery ofconstituent amino acids for subsequent intracellular GSH resynthesis. AsGSH is the main water-soluble antioxidant within the cell, GGT is animportant component of the cell protection system against oxidativestress. On the other hand, other pathophysiologically relevant compoundsare also GGT substrates, in particular all GSH conjugates, includingleukotriene C4, S-nitroso-glutathione (GSNO) and GSH adducts ofxenobiotics formed by the action of glutathione-S-transferases.

Several studies showed that GGT is up-regulated in different cell typesafter acute exposure to oxidative stress. A connection between GGTexpression and activation of Ras-MAPK pathways has been demonstrated incolon cancer cells following gamma-irradiation, as well as exposure tooxidative stress. Reactive oxygen species (ROS) have been implicated inthe process of carcinogenesis, and at the same time, the redoxregulation of many genes in response to ROS/electrophiles seems tomodulate GGT expression; this could altogether explain the increased GGTexpression described in tumors.

The distribution and concentration of GGT in human tumors presentseveral differences from what is observed in normal tissues. Increasedlevels of GGT have been observed in cancer of ovary, colon, liver,astrocytic glioma, soft tissue sarcoma, melanoma, leukemias, and lung.In studies on melanoma cells in vitro and in vivo, elevated GGT activitywas found to accompany an increased invasive growth, and a positivecorrelation was described between GGT expression and unfavourableprognostic signs in human breast cancer.

GGT Functions in the Cancer Cell

Several studies have addressed the relationships of GGT activity withthe malignant phenotype, in particular the question of whether anincreased GGT expression itself plays any active role in neoplastictransformation. The involvement of GGT in cellular resupply of GSH, andthe increased resistance to pro-oxidant drugs observed in severalGGT-expressing cell lines, indicated the inclusion of GGT among thecomponents of cellular defensive systems. On the other hand, a number ofrecent findings indicate that, under particular conditions, themetabolism of GSH by GGT can exert pro-oxidant effects, with modulatoryeffects on several redox-sensitive processes.

GSH is synthesized inside cells and transported in the extracellularmilieu through plasma-membrane transporters, down a concentrationgradient (millimolar vs. micromolar). Extracellular metabolism of GSH byGGT, in concert with cell surface dipeptidases, promotes the release andrecovery by cells of constituent amino acids, among which are glutamicacid and essential cysteine. Indeed, studies performed both in vitro andin vivo showed that GGT-overexpressing cells are able to utilizeextracellular GSH as a source of cysteine more efficiently, resulting ina selective growth advantage both at physiological and at limitingcysteine concentrations. It was, in fact, observed that a short (2 h)inhibition of GGT is able to lower intracellular cysteine inGGT-positive cervical carcinoma cell lines. Thus, the favouring actionof GGT in tumor growth is twofold, in that it operates as a source ofessential amino acids both for protein synthesis and for the maintenanceof intracellular levels of GSH (FIG. 2).

Adequate levels of GSH are the basis of cellular resistance againstseveral electrophilic/alkylating compounds, and GGT-overexpressing cellshave been reported to be more resistant to hydrogen peroxide, andchemotherapics such as doxorubicin, cisplatin and 5-fluorouracil. Inmelanoma cells, GSH depletion and GGT inhibition significantly increasedcytotoxicity of oxidative stress conditions.

GGT activity, by converting poorly reactive GSH into highly reactivecysteinyl-glycine, is able to trigger the formation of cisplatin/thiolcomplexes in the extracellular space, resulting in lower cellularaccumulation of cisplatin, reduced DNA platination and reducedcytotoxicity.

It has been reported that GGT can exert pro-oxidant effects at themembrane surface level, and in the extracellular microenvironment. Thisphenomenon was explained with the high reactivity of cysteinyl-glycine,the GGT product of GSH cleavage. The lower pKa of the cysteinyl-glycinethiol makes it able to dissociate more rapidly at physiological pH, andto reduce extracellular transition metal cations (in particular Fe³⁺ andCu²⁺) more efficiently than GSH itself. Iron reduction by GSH, in fact,might be limited by the chelating properties of the alpha-carboxyl groupof the glutamate residue, affecting sterical and redox interactions ofthe cysteine thiol. GGT-catalyzed removal of glutamic acid causes adecrease of the cysteine thiol pKa and makes it free to interact withiron.

In addition, GGT activity can promote the release of free iron fromtransferrin, thus promoting the uptake of iron by cancer cells. Thiseffect may play an additional role in supplying iron to malignant cells,and the role of iron in carcinogenesis is well established.

The pro-oxidant activity of GGT was also recently shown to promote theiron-dependent oxidative damage of DNA in GGT-transfected melanomacells, thus potentially contributing to DNA damage and increasedmutation risk in cancer cells.

A major role in such regulation is played by cysteine thiols, which canundergo different redox modifications, all of which possibly reflectinga distinct functional state of a protein. A number of such phenomenahave been described in proteins participating in crucial cell functions,such as cell proliferation, apoptosis, cell adhesion and geneexpression, whose alterations are of primary importance in progressionof cancer and other diseases. GGT activity can promote the oxidation ofthiol groups in cell surface proteins, a process involving hydrogenperoxide and formation of mixed disulfides (‘protein S-thiolation’). Themodulatory effects of GGT-mediated pro-oxidant reactions couldcontribute to the resistance phenotype of GGT-expressing cancer cells,by regulating both signal transduction pathways involved inproliferation/apoptosis balance, as well as by inducing protectiveadaptations in the pool of intracellular antioxidants.

As discussed above, the antioxidant adaptations associated with GGTexpression are the basis for an increased cellular tolerance againstoxidative stress, which itself is a factor of resistance to the effectsof pro-oxidant drugs. Association of more agents in therapy can,however, overcome such resistance; in a recent paper, for example, thecombination of arsenic trioxide with subtoxic concentrations of ascorbicacid resulted in a sensitization to apoptotic cell death ofGGT-transfected/arsenic trioxide-resistant melanoma cells.

GGT expression and activity in the pathophysiology of cellular processesinvolving nitric oxide (NO) and related compounds, GSNO in the firstplace. Treatments of human cancer cells with NO and NO mimetics caneffectively restore the sensitivity of resistant cell populations to thecytotoxic effects of chemotherapeutics. NO thus acts as achemosensitizing agent. GGT selectively metabolizes GSNO, thus promotingthe release of its NO load.

Methods of Administration of GGCI

The present invention is based a surprising, and unexpected, discoverythat GGCI agents have the ability to modulate amino acid transport byselectively acting as analogs of 5-oxoproline and modulate thegamma-glutamyl cycle.

In addition, aspects of the present invention are based on thesurprising discovery that-GGCI have the ability to treat, prevent,and/or reduce glutathione in cancer cells.

For the purpose of the current disclosure, the following definitionsshall, in their entireties, be used to define technical terms, and todefine the scope of the composition of matter for which protection issought in the claims.

The instant disclosure provides methods of treatment by administrationto a subject of one or more effective dose(s) of GGCI for a duration toachieve the desired therapeutic effect. The subject is preferably amammal, including, but not limited to, animals such as cows, pigs,horses, chickens, cats, dogs, etc., and is most preferably human.

Various delivery systems are known, and can be used to administer GGCIin accordance with the methods of the invention, e.g., encapsulation inliposomes, microparticles or microcapsules. Methods of introductioninclude, but are not limited to, topical, subcutaneous, intradermal,intramuscular, intraperitoneal, intravenous, subcutaneous, intranasal,epidural, and oral routes. For treatment of certain cancers, topical,subcutaneous, intradermal, and systemic deliveries can be particularlyefficacious.

GGCI can be administered by any convenient route, for example byinfusion or bolus injection, by absorption through epithelial ormucocutaneous linings (e.g., oral mucosa, rectal and intestinal mucosa,etc.) and may be administered together with other biologically activeagents. Administration can be systemic or local. In addition, it may bedesirable to introduce pharmaceutical compositions comprising GGCI intothe central nervous system by any suitable route, includingintraventricular and intrathecal injection; intraventricular injectionmay be facilitated by an intraventricular catheter, for example,attached to a reservoir, such as an Ommaya reservoir. Pulmonaryadministration can also be employed, e.g., by use of an inhaler ornebulizer, and formulation with an aerosolizing agent. It may bedesirable to administer the pharmaceutical compositions comprising GGCIlocally to the area in need of treatment; this may be achieved, forexample, and not by way of limitation, by topical application, byinjection, by means of a catheter, by means of a suppository, or bymeans of an implant, said implant being of a porous, non-porous, orgelatinous material, including membranes, such as Silastic™ membranes,or fibers.

Still other modes of administration of GGCI involve delivery in acontrolled release system. In certain embodiments, a pump may be used(see Langer, supra; Sefton, CRC Crit. Ref. Biomed. Eng. 14:201 (1987);Buchwald et al., Surgery 88:507 (1980); Saudek et al., N. Engl. J. Med.321:574 (1989)). Additionally polymeric materials can be used (seeMedical Applications of Controlled Release, Langer and Wise (eds.), CRCPres, Boca Raton, Fla. (1974); Controlled Drug Bioavailability, DrugProduct Design and Performance, Smolen and Ball (eds.), Wiley, N.Y.(1984); Ranger and Peppas, J. Macromol. Sci. Rev. Macromol. Chem. 23:61(1983; see also Levy et al., Science 228:190 (1985); During et al., Ann.Neurol. 25:351 (1989); Howard et al., J. Neurosurg. 71:105 (1989)), or acontrolled release system can be placed in proximity of the therapeutictarget, i.e., the brain, thus requiring only a fraction of the systemicdose (see, e.g., Goodson, in Medical Applications of Controlled Release,supra, vol. 2, pp. 115-138 (1984)). Other controlled release systems arediscussed in the review by Langer (Science 249:1527-1533 (1990)).

Forms and Dosages of GCGI

As used herein, for cancer treatment, lyophilized formulation and liquidformulation suitable for injection are particularly efficacious.Suitable dosage forms of GGCI for use in embodiments of the presentinvention encompass physiologically/pharmaceutically acceptable carriersthat are inherently non-toxic and non-therapeutic. Examples of suchcarriers include ion exchangers, alumina, aluminum stearate, lecithin,serum proteins, such as human serum albumin, buffer substances, such asphosphates, glycine, sorbic acid, potassium sorbate, partial glyceridemixtures of saturated vegetable fatty acids, water, salts, orelectrolytes such as protamine sulfate, disodium hydrogen phosphate,potassium hydrogen phosphate, sodium chloride, zinc salts, colloidalsilica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-basedsubstances, P6N (Neumedicines, Pasadena, Calif.) and PEG. Carriers fortopical or gel-based forms of GGCI polypeptides include polysaccharides,such as sodium carboxymethylcellulose or methylcellulose,polyvinylpyrrolidone, polyacrylates,polyoxyethylene-polyoxypropylene-block polymers, PEG, and wood waxalcohols. For all administrations, conventional depot forms are suitablyused. Such forms include, for example, microcapsules, nano-capsules,liposomes, plasters, inhalation forms, nose sprays, sublingual tablets,and sustained-release preparations.

Suitable examples of sustained-release preparations includesemipermeable matrices of solid hydrophobic polymers containing thepolypeptide, which matrices are in the form of shaped articles, e.g.,films, or microcapsules. Examples of sustained-release matrices includepolyesters, hydrogels (for example, poly(2-hydroxyethyl-methacrylate) asdescribed by Langer et al., supra and Langer, supra, orpoly(vinylalcohol), polylactides (U.S. Pat. No. 3,773,919), copolymersof L-glutamic acid and .gamma. ethyl-L-glutamate (Sidman et al, supra),non-degradable ethylene-vinyl acetate (Langer et al., supra), degradablelactic acid-glycolic acid copolymers such as the Lupron Depot™(injectable microspheres composed of lactic acid-glycolicacid copolymerand leuprolide acetate), and poly-D-(−)-3-hydroxybutyric acid. Whilepolymers, such as ethylene-vinyl acetate and lactic acid-glycolic acid,enable release of molecules for over 100 days, certain hydrogels releaseproteins for shorter time periods. When encapsulated GGCI polypeptidesremain in the body for a long time, they may denature, or aggregate, asa result of exposure to moisture at 37° C., resulting in a loss ofbiological activity and possible changes in immunogenicity. Rationalstrategies can be devised for stabilization depending on the mechanisminvolved. For example, if the aggregation mechanism is discovered to beintermolecular S—S bond formation through thio-disulfide interchange,stabilization may be achieved by modifying sulfhydryl residues,lyophilizing from acidic solutions, controlling moisture content, usingappropriate additives, and developing specific polymer matrixcompositions.

In the case of administrations over several days or longer, depending onthe condition, the treatment is sustained until a desired suppression ofdisease symptoms occurs. However, other dosage regimens may be useful.The progress of this therapy is easily monitored by conventionaltechniques and assays.

Therapeutic formulations of GGCI are prepared for storage by mixingGGCI, having the desired degree of purity, with optional physiologicallyacceptable carriers, excipients, or stabilizers (Remington'sPharmaceutical Sciences, 16th edition, Osol, A., Ed., (1980)), in theform of lyophilized cake, or aqueous solutions. Acceptable carriers,excipients, or stabilizers are nontoxic to recipients at the dosages andconcentrations employed, and include buffers such as phosphate, citrate,and other organic acids; antioxidants including ascorbic acid; lowmolecular weight (less than about 10 residues) polypeptides; proteins,such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymerssuch as polyvinylpyrrolidone; amino acids such as glycine, glutamine,asparagine, arginine, or lysine; monosaccharides, disaccharides, andother carbohydrates including glucose, mannose, or dextrins; chelatingagents such as EDTA; sugar alcohols such as mannitol or sorbitol;salt-forming counter-ions such as sodium; and/or non-ionic surfactantssuch as Tween®, Pluronics™ or polyethylene glycol (PEG).

The term “buffer”, as used herein, denotes a pharmaceutically acceptableexcipient, which stabilizes the pH of a pharmaceutical preparation.Suitable buffers are well known in the art and can be found in theliterature. Pharmaceutically acceptable buffers include, but are notlimited to, histidine-buffers, citrate-buffers, succinate-buffers,acetate-buffers, phosphate-buffers, arginine-buffers, or mixturesthereof. The abovementioned buffers are generally used in an amount ofabout 1 mM to about 100 mM, of about 5 mM to about 50 mM and of about10-20 mM. The pH of the buffered solution can be at least 4.0, at least4.5, at least 5.0, at least 5.5 or at least 6.0. The pH of the bufferedsolution can be less than 7.5, less than 7.0, or less than 6.5. The pHof the buffered solution can be about 4.0 to about 7.5, about 5.5 toabout 7.5, about 5.0 to about 6.5, and about 5.5 to about 6.5 with anacid or a base known in the art, e.g. hydrochloric acid, acetic acid,phosphoric acid, sulfuric acid and citric acid, sodium hydroxide andpotassium hydroxide. As used herein when describing pH, “about” meansplus or minus 0.2 pH units.

As used herein, the term “surfactant” can include a pharmaceuticallyacceptable excipient which is used to protect protein formulationsagainst mechanical stresses, like agitation and shearing. Examples ofpharmaceutically acceptable surfactants include polyoxyethylensorbitanfatty acid esters (Tween), polyoxyethylene alkyl ethers (Brij),alkylphenylpolyoxyethylene ethers (Triton-X),polyoxyethylene-polyoxypropylene copolymer (Poloxamer, Pluronic), andsodium dodecyl sulphate (SDS). Suitable surfactants includepolyoxyethylenesorbitan-fatty acid esters such as polysorbate 20, (soldunder the trademark Tween 20®) and polysorbate 80 (sold under thetrademark Tween 80®). Suitable polyethylene-polypropylene copolymers arethose sold under the names Pluronic® F68 or Poloxamer 188®. SuitablePolyoxyethylene alkyl ethers are those sold under the trademark Brij®.Suitable alkylphenolpolyoxyethylene esthers are sold under the tradenameTriton-X. When polysorbate 20 (Tween 20®) and polysorbate 80 (Tween 80®)are used, they are generally used in a concentration range of about0.001 to about 1%, of about 0.005 to about 0.2% and of about 0.01% toabout 0.1% w/v (weight/volume).

As used herein, the term “stabilizer” can include a pharmaceuticallyacceptable excipient, which protects the active pharmaceuticalingredient and/or the formulation from chemical and/or physicaldegradation during manufacturing, storage and application. Chemical andphysical degradation pathways of protein pharmaceuticals are reviewed byCleland et al., Crit. Rev. Ther. Drug Carrier Syst., 70(4):307-77(1993); Wang, Int. J. Pharm., 7S5(2): 129-88 (1999); Wang, Int. J.Pharm., 203 (1-2): 1-60 (2000); and Chi et al, Pharm. Res., 20(9):1325-36 (2003). Stabilizers include, but are not limited to, sugars,amino acids, polyols, cyclodextrines, e.g.hydroxypropyl-beta-cyclodextrine, sulfobutylethyl-beta-cyclodextrin,beta-cyclodextrin, polyethylenglycols, e.g. PEG 3000, PEG 3350, PEG4000, PEG 6000, albumine, human serum albumin (HSA), bovine serumalbumin (BSA), salts, e.g., sodium chloride, magnesium chloride, calciumchloride, chelators, e.g., EDTA as hereafter defined. As mentionedhereinabove, stabilizers can be present in the formulation in an amountof about 10 to about 500 mM, an amount of about 10 to about 300 mM, orin an amount of about 100 mM to about 300 mM. In some embodiments,exemplary GGCI can be dissolved in an appropriate pharmaceuticalformulation, wherein it is stable.

GGCI also may be entrapped in microcapsules prepared, for example, bycoacervation techniques or by interfacial polymerization (for example,hydroxymethylcellulose or gelatin-microcapsules andpoly-(methylmethacylate) microcapsules, respectively), in colloidal drugdelivery systems (for example, liposomes, albumin microspheres,microemulsions, nano-particles, and nanocapsules), or in macroemulsions.Such techniques are disclosed in Remington's Pharmaceutical Sciences,supra.

GGCI to be used for in vivo administration must be sterile. This isreadily accomplished by filtration through sterile filtration membranes,prior to, or following, lyophilization and reconstitution. GGCIordinarily will be stored in lyophilized form, or in solution.Therapeutic GGCI compositions generally are placed into a containerhaving a sterile access port, for example, an intravenous solution bag,or vial, having a stopper pierceable by a hypodermic injection needle.

When applied topically, GGCI is suitably combined with otheringredients, such as carriers and/or adjuvants. There are no limitationson the nature of such other ingredients, except that they must bephysiologically acceptable and efficacious for their intendedadministration, and cannot degrade the activity of the activeingredients of the composition. Examples of suitable vehicles includeointments, creams, gels, or suspensions, with, or without, purifiedcollagen. The compositions also may be impregnated into transdermalpatches, plasters, and bandages, preferably in liquid or semi-liquidform.

For obtaining a gel formulation, GGCI formulated in a liquid compositionmay be mixed with an effective amount of a water-soluble polysaccharide,or synthetic polymer, such as PEG, to form a gel of the proper viscosityto be applied topically. The polysaccharide that may be used includes,for example, cellulose derivatives, such as etherified cellulosederivatives, including alkyl celluloses, hydroxyalkyl celluloses, andalkylhydroxyalkyl celluloses, for example, methylcellulose, hydroxyethylcellulose, carboxymethyl cellulose, hydroxypropyl methylcellulose, andhydroxypropyl cellulose; starch and fractionated starch; agar; alginicacid and alginates; gum arabic; pullullan; agarose; carrageenan;dextrans; dextrins; fructans; inulin; mannans; xylans; arabinans;chitosans; glycogens; glucans; and synthetic biopolymers; as well asgums such as xanthan gum; guar gum; locust bean gum; gum arabic;tragacanth gum; and karaya gum; and derivatives and mixtures thereof.The preferred gelling agent herein is one that is inert to biologicalsystems, nontoxic, simple to prepare, and not too runny or viscous, andwill not destabilize the GGCI molecule held within it.

Preferably the polysaccharide is an etherified cellulose derivative,more preferably one that is well defined, purified, and listed in USP,e.g., methylcellulose and the hydroxyalkyl cellulose derivatives, suchas hydroxypropyl cellulose, hydroxyethyl cellulose, and hydroxypropylmethylcellulose. Most preferred herein is methylcellulose.

The polyethylene glycol useful for gelling is typically a mixture of lowand high molecular weight PEGs to obtain the proper viscosity. Forexample, a mixture of a PEG of molecular weight 400-600 with one ofmolecular weight 1500 would be effective for this purpose, when mixed inthe proper ratio to obtain a paste.

The term “water soluble”, as applied to the polysaccharides and PEGs, ismeant to include colloidal solutions and dispersions. In general, thesolubility of the cellulose derivatives is determined by the degree ofsubstitution of ether groups, and the stabilizing derivatives usefulherein should have a sufficient quantity of such ether groups peranhydroglucose unit in the cellulose chain to render the derivativeswater soluble. A degree of ether substitution of at least 0.35 ethergroups per anhydroglucose unit is generally sufficient. Additionally,the cellulose derivatives may be in the form of alkali metal salts, forexample, the Li, Na, K, or Cs salts.

If methylcellulose is employed in the gel, preferably it comprises about2-5%, more preferably about 3%, of the gel and GGCI is present in anamount of about 300-1000 mg per ml of gel.

An effective amount of GGCI to be employed therapeutically will depend,for example, upon the therapeutic objectives, the route ofadministration, and the condition of the patient. Accordingly, it willbe necessary for the therapist to titer the dosage and modify the routeof administration, as required to obtain the optimal therapeutic effect.Typically, the clinician will administer GGCI until a dosage is reachedthat achieves the desired effect. In certain embodiments, theappropriate dosing can be determined based on an amount of GGCIadministered per surface area of the affected region.

“Near the time of administration of the treatment” refers to theadministration of GGCI at any reasonable time period, either before,and/or after the administration of the treatment, such as about onemonth, about three weeks, about two weeks, about one week, several days,about 120 hours, about 96 hours, about 72 hours, about 48 hours, about24 hours, about 20 hours, several hours, about one hour or minutes. Nearthe time of administration of the treatment may also refer to either thesimultaneous, or near simultaneous, administration of the treatment andGGCI, i.e., within minutes to one day.

“Chemotherapy” refers to any therapy that includes natural or syntheticagents now known, or to be developed in the medical arts. Examples ofchemotherapy include the numerous cancer drugs that are currentlyavailable. However, chemotherapy also includes any drug, natural orsynthetic, that is intended to treat a disease state. In certainembodiments of the invention, chemotherapy may include theadministration of several state of the art drugs intended to treat thedisease state. Examples include combined chemotherapy with docetaxel,cisplatin, and 5-fluorouracil, for patients with locally advancedsquamous cell carcinoma of the head (Tsukuda, M. et al., Int J ClinOncol. 2004 June; 9 (3): 161-6), and fludarabine and bendamustine inrefractory and relapsed indolent lymphoma (Konigsmann M, et al., LeukLymphoma. 2004; 45 (9): 1821-1827).

As used herein, exemplary sources of therapeutic or accidental ionizingradiation can include, for example, alpha, beta, gamma, x-ray, andneutron sources.

“Radiation therapy” refers to any therapy where any form of radiation isused to treat the disease state. The instruments that produce theradiation for the radiation therapy are either those instrumentscurrently available, or to be available in the future.

“Chemoprotection or radioprotection” refers to protection from, or anapparent decrease in, the associated hematopoietic toxicity of atreatment intended to target the disease state.

“Solid tumors” generally refers to the presence of cancer of bodytissues other than blood, bone marrow, or the lymphatic system.

EXAMPLES

The invention is now described with reference to the following Examples.These Examples are provided for the purpose of illustration only, andthe invention is not limited to these Examples, but rather encompassesall variations that are evident as a result of the teaching providedherein.

Prior to the experiments described herein, there were no publishedprotocol that allows for compositions and methods comprising specificGGCI 5-oxoproline analog preparation for treating cancer and otherproliferative diseases. Aspects and embodiments of the instantdisclosure stem from the unexpected discovery that certain GGCIformulations have surprising, and unexpected, utility and efficacy whenadministered to a subject.

By way of example, a method to prepare therapeutically effectiveradioprotective GGCI formulation was developed. The compounds of theinvention were prepared, as outlined below, according to the methodsdescribed herein. However, the invention is not limited to thesemethods; the compounds may also be prepared as described forstructurally related compounds in the literature.

Example 1: Synthesis of Exemplary Gamma Glutamyl Cycle Inhibitors (GGCI

Exemplary GGCI compounds were synthesized according to the followingsynthesis schemes.

The compounds of formula-I-VII can be obtained by methods describedherein and shown in FIG. 1. The compound of formula III, for example,2-imino-3-p-methoxybenzyl-4 sulfanyl-5 dimethyl 1-carboxylic acid, wasprepared as follows: Equimolar quantities of (p-methoxybenzaldehyde), dimethyl cysteine and manganese dioxide were dissolved in 2 liters of 70%ethanol. The mixture was made in a rotary evaporator and the temperaturewas raise to 70 degrees centigrade. After about 1 hour, all theingredients in the mixture dissolved. The volume was then reduced by oneliter. The solution was then left in the flask to cool down overnight atroom temperature. The next day, the precipitating white crystals of GCLwere filtered and then dried in a vacuum oven. The yield was estimatedto be about 80%.

In some embodiments this invention also relates to the reactionintermediates for, or within, any of the synthesis schemes disclosedherein. The compounds of this invention may also include opticalisomers, and pharmaceutically acceptable salts of any of the compoundsdisclosed herein.

In some embodiments, this invention also relates to products generatedby the synthetic schemes disclosed herein, where L-penicillamine,L-cysteine or cystamine is used as a reactant.

Example 2: Demonstration of the Efficacy of GGCI in the Treatment ofNude Mice Inoculated with Human Melanoma

In order to examine the survival rate of athymic nude mice, inoculatedintravenously with tumors, one group of the inoculated mice was treatedwith BA-GGCI, and a second group of the inoculated mice were treatedwith placebo, and the effects of treatment with BA-GGCI and placebo werecompared.

Two subgroups of nude mice were examined: a control group and anexperimental group. The groups included a total of twenty athymic nudemice (ten control and ten experimental), each irradiated with 400 radsof radiation and inoculated with Human Melanoma cells 624 at3.0×10,000,000 cells per mouse. Treatment of the experimental group withracemic BA-GGCI commenced at 24 hours after the inoculation. Thetreatment was administered intraperitoneally (I.P.) at a dose of 100mg/kg in 2 cc of saline every day, six days a week. The control groupreceived placebo (2 cc saline IP), every day, six days a week.

The subjects were followed up for 120 days. The results indicated that,in the Control group, ten out of ten subjects died (no survival)whereas, ten out of ten subjects in the treated group were all alive.Two of the subjects developed small tumors after stopping the treatment.

Racemic SA-GGCI and racemic PMB-GGCI were also tested, each givingresults similar to those obtained with racemic BA-GGCI.

Example 3: Demonstration of the Efficacy of Using GGCI in the Treatmentof Human Lung Cancer Using the Nude Mouse Model

The efficacy of an exemplary GGCI in the treatment of human lung cancer,using the nude mouse model was demonstrated in a study. In order toexamine survival of athymic nude mice inoculated intravenously withtumors, one group of the inoculated mice was treated with racemicBA-GGCI, and a second group of the inoculated mice were treated withplacebo, and the effects of treatment with BA-GGCI and placebo werecompared.

Two subgroups of nude male mice where examined: A control group and anexperimental group. The groups included twenty athymic nude mice (tencontrol and ten experimental) subjects, each irradiated with 400 rads ofradiation and inoculated with lung CA CRL5891 at 3×10,000,000 cells permouse. Interventional treatment was identical to the first study asabove.

The subjects were followed up for 120 days. In the Control group, eightof ten subjects died. Two of the surviving mice developed a large tumor.In the treated group, all mice remained alive (none with detectabletumor).

Racemic SA-GGCI and racemic PMB-GGCI were also tested, each givingresults similar to those obtained with racemic BA-GGCI.

Example 4: Demonstration of Efficacy Based on Human Data

Two patients with advanced prostate cancer were treated under acompassionate use program with an exemplary GGCI

Racemic BA-GGCI was administered to two human subjects who werereceiving hormonal therapy for 12 and 14 months respectively. When thehuman subjects failed to react to the hormonal therapy, and/or any otherconventional therapy, administration of the GGCI treatment began.

At the onset of the GGCI treatment, both patients were bedridden withPSA (Prostate Specific Antigen) values of 340 and 180 ng/mLrespectively. Both subjects presented with multiple bone metastases, andagonizing pains. The GGCI treatment protocol comprised 600 mg of GGCIcapsule 3 times/day (formulated for human based on less then 5% of theLD50 toxicity on mice). The following results were observed:

The first human patient (subject #1) presented with the following, inresponse to exemplary GGCI treatment: The subjects' pain level subsidedwithin 10 days after receiving treatment. The Subject recovered enoughto return to his regular activities within a month. Subject's PSA valuedropped from 340 to 18 units. The PSA level continued to drop to 5units. The bone CAT scan showed substantial remission. Subject feltnormal for 28 months before he eventually passed away.

The following human patient (subject #2) presented with the following:The pains subsided after 7 days. The subject returned to his normalactivities within 2-3 weeks. The subject's PSA dropped to 16 units. Thesubject was still alive, and feeling well, 36 months after initiation ofthe treatment. Subject is currently still receiving the GGCI treatmenton a daily basis.

Treatment with racemic SA-GGCI gave results similar to those obtainedwith B-GGCI treatment, although patients to whom SA-GGCI wereadministered subjectively felt better than patients to whom BA-GGCI wasadministered.

Example 5: Demonstration of Surprising and Unexpected Efficacy UsingExemplary GGCI Prepared by FIG. 1 Synthesis Using L-Penicillamine

Relative activities of the exemplary enantiomeric GGCI compounds of thisinvention were compared. Conjugates of benzaldehyde, salicylaldehyde andpara-methoxybenzaldehyde were prepared, using either enantiomeric L- orD-penicillamine as the second reactant. The efficacy of racemic BA-GGCI,racemic SA-GGCI and racemic PMB-GGCI in the treatment of human prostatecancer was tested using the nude mouse model as in Example 2, exceptthat the nude mice were inoculated intravenously with a human prostatetumor cell line. One group of the inoculated mice was treated with theracemic BA-GGCI and a control group of the inoculated mice was treatedwith placebo, and the effects of treatment with GGCI and placebo werecompared. Response to treatment was monitored by changes in [PSA]. Theresults were similar to those obtained with other nude mouse-human tumormodels, where the group of mice treated with the racemic GGCI had asignificantly higher survival rate than the control group. RacemicSA-GGCI or PMB-GGCI were also tested, and gave similar results.

The exemplary L- and D-enantiomer BA-GGCIs were prepared in accordancewith synthetic scheme of FIG. 1 using L-penicillamine. Preparation ofthe GGCI using the same synthetic scheme with D-penicillamine asstarting material yielded a GGCI that had no measurable effect on thesubject.

When the activity of (L)-BA-GGCI was tested compared to thecorresponding racemate, the (L) compound were at least twice as activeas the corresponding racemic mixture. Similar results were obtained forL-SA-GGCI and L-PMB-GGCI compared to their corresponding racemate.

Example 6: Toxicity Study, Demonstration of Safety and Efficacy

LD50 data was measured, and exemplary gamma-glutamyl cycle inhibitor'stoxicity study was conducted on Balb C Mice. A conjugate ofL-penicillamine and methyl glyoxal (MGPA) was adminstered at about 4500mg/kg ip, 5000 mg/kg oral. A conjugate of L-penicillamine andpara-methoxyphenyl (PMPA) was administered at 5250 mg/kg ip, 5500 mg/kgoral; and a conjugate of L-penicillamine and citronellal (CNPA) wasadministered at 3250 mg/kg ip, 4500 mg/kg oral.

Example 7: Mouse Toxicity Data

Summary of LD50 Determination with a conjugate of L-penicillamine andsalicylaldehyde (L-SAPA), a conjugate of L-penicillamine andbenzaldehyde (L-BAPA), a conjugate of L-penicillamine and pyruvicaldehyde (L-PAPA) and a conjugate of L-penicillamine and glutaricdialdehyde (L-GAPA) in B6C3F₁ Mice.

Calculated GGCI LD50 1/10 Compound Schedule Route mg/kg/inj. LD₅₀ L-SAPADay 1 ip >5000 500 Day 1 oral >5000 500 Day 1-5 ip 3750 375 Day 1-5oral >5000 500 L-BAPA Day 1 ip 884 88.4 Day 1 oral 3553 355 Day 1-5 ip884 88.4 Day 1-5 oral 2158 216 L-PAPA Day 1 ip >5000 500 Day 1oral >5000 500 Day 1-5 ip 2771 277 Day 1-5 oral >5000 500 L-GAPA Day 1ip 3749 375 Day 1 oral >5000 500 Day 1-5 ip 1690 169 Day 1-5 oral >5000500

Example 8: Exemplary Assay for Determination of Toxicity andDemonstration of Safety in Animal Model

Sample: L-Thiazolidine-di-methyl-carboxylic acid: “L-BAPA” powder wasmixed in the food (pellets).

Subjects were examined for: Sub-acute (4 weeks) per os (via food)toxicity of L-BAPA to mice.

Experimental Procedure

Animals and Husbandry:

Forty females and forty male CD1 mice, 8-10 weeks old, were housed 5 percage (milipore filtered top cages), half of them used as controls,receiving normal mouse diet (prepared at the breeding center foodplant). The other half were the experimental group and received samefood composition in which 0.6 g L-Thiazolidine-di-methyl-carboxylic acidin kg food was mixed and pelleted in smaller pellet machine. This foodcontains 12% humidity, as compared with 6% humidity of the control diet.The animals were fed ad libitum. All animals were weighed weekly andfood consumption was recorded. Possible clinical or pharmaceuticaleffects were checked daily. After 4 weeks, the mice were put intometabolic cages for 24 hours, their urine was collected, and then theanimals were bled before sacrificing. The blood was analyzed and bonemarrow smears were prepared for differential count.

The reason for putting 40 mice in a group was to assure enough blood andurine for analysis, so all the blood clinical chemistry and urinalysisare of a pool of 2 mice each. All other results are individual results,performed randomly on one of each 2 mouse group.

The following organs were examined histologically: adrenals, brain, eye,gonads, heart, intestines (colon, caecum, duodenum, ileum, rectum)kidneys, liver, lungs, lymph nodes (mesenterial and inguinal) mammarygland, mediastinum, esophagus, pancreas, pituitary, salivary gland,skeletal muscle, skin, spinal cord, spleen, stomach, thyroid, urinarybladder and uterus. The organs were fixed in Bouin's solution andstained with hematoxylin-eosin-phosphomolybdic-acid light green stain.Weights for the adrenals, gonads, kidneys, liver and pituitary wererecorded and the ratio organ weight/body weight was calculated.

The following lab studies were performed:

Hematology: Hemoglobin, hematocrit, erythrocyte count, leukocyte count.

Clinical chemistry: alkaline phosphatase, blood urea nitrogen, serumglutamic, pyruvic transaminase, blood sugar.

Urinalysis: appearance occult blood, protein Ph, bilirubin, ketones,glucose, nitrites, urobilinogen.

Results

During the observation and dosing period of 4 weeks, the mice wereexamined daily for possible clinical symptoms, but no clinical or othereffect could be observed.

The results of all tests performed are summarized below:

1. Body weight: The animals ended the experiment gaining weight, andthere is no significant difference between the experimental group andthe control group.

2. Food consumption: From the tables we see that more L-BAPA containingexperimental food was consumed by the experimental group then normalfood by the control, but this is due to the fact that the humidity ofthe experimental food is much higher.

3. Organ weight and ratio: Organ/body weight: No significant differencebetween the experimental and the control group is noted. All values arewithin the normal values and no significant differences between theexperimental and the control group is seen.

4. Blood clinical chemistry and urinalysis: All values are within thenormal range and no significant difference between the control and theexperimental groups is noted.

(The protein traces which were noted in all mice is most probably due toslight contamination of the urine by food).

5. Blood cell analysis and differential count: All values are within thenormal range and no significant difference between the control and theexperimental groups is noted.

6. Bone marrow differential count: All values are within the normalrange and no significant difference between the control and theexperimental groups is noted.

Histopathology

Histological examinations were performed for 10 male and 10 females foreach group. Thirty-one organs were examined for each animal. Cerebellarand cerebral regions of the brain looked normal, with no signs ofperivascular reaction. The eyes were normal. In the testes,spermatogenesis was normally presented. In the ovaries, follicles of allstages were observed. The heart muscle and intestines were normal andthe mammary gland “juvenile” and normal. Normal patterns were noted alsofor the lymph nodes (inguinal, mesenterial) mediastinum, esophagus,pancreas, prostate, uterus, pituitary, salivary glands, skeletal muscle,skin, spinal cord, spleen, stomach, thymus, and urinary bladder. In thekidneys, glomeruli and Bowman's capsule are nicely presented. Proximal,distal, convoluted and collecting tubuli are intact and do not containany material. The peribronchi and alveolar areas of the lungs are clear.In the liver, the portal spaces are clear, normal looking epithelial andsinusoidal elements.

In two mice of the control, and one mouse of the experimental group, afew lipoid vacuoles in the hippocampus (artifact?) are seen. No otherpathological or other changes could be observed.

CONCLUSIONS

As a demonstration of safety, L-Thiazolidine-di-methyl-carboxylic-acid(“L-BAPA”) mixed in the food (0.6 g in kg food) and fed ad libitum for 4weeks does not produce any clinical or pathological changes to mice.

Patents, patent applications, publications, scientific articles, books,web sites, and other documents and materials referenced or mentionedherein are indicative of the levels of skill of those skilled in the artto which the inventions pertain. Each such referenced document andmaterial is hereby incorporated by reference to the same extent as if ithad been incorporated by reference in its entirety individually or setforth or reprinted herein in its entirety. Additionally, all claims inthis application, and all priority applications, including but notlimited to original claims, are hereby incorporated in their entiretyinto, and form a part of, the written description of the invention.Applicants reserve the right to physically incorporate into thisspecification any and all materials and information from any suchpatents, applications, publications, scientific articles, web sites,electronically available information, and other referenced materials ordocuments. Applicants reserve the right to physically incorporate intoany part of this document, including any part of the writtendescription, and the claims referred to above, including, but notlimited to, any original claims.

The inventions have been described broadly and generically herein. Eachof the narrower species and subgeneric groupings falling within thegeneric disclosure also form part of these inventions. This includes thegeneric description of each invention which hereby include, includingany claims thereto, a proviso or negative limitation removing, oroptionally allowing the removal of, any subject matter from the genus,regardless of whether or not the excised materials, or options, werespecifically recited or identified in haec verba herein, and all suchvariations form a part of the original written description of theinventions. In addition, where features, or aspects, of an invention aredescribed in terms of a Markush group, the invention shall be understoodthereby to be described in terms of each and every, and any, individualmember or subgroup of members of the Markush group.

Although the invention has been described in terms of synthesis of GGCIsand GGCI salts, it should be recognized that the routes, steps, andintermediates described in the disclosure are applicable to thesynthesis of CGI.

The inventions illustratively described and claimed herein can suitablybe practiced in the absence of any element or elements, limitation orlimitations, not specifically disclosed herein, or described herein, asessential. Thus, for example, the terms “comprising,” “including,”“containing,” “for example”, etc., shall be read expansively and withoutlimitation. The term “including” means “including but not limited to.”The phrase “for example” is not limited to, or by, the items that followthe phrase. All references to things “known in the art” include allthose things and equivalents and substitutes, whether now known, orlater discovered.

In claiming their inventions, the inventors reserve the right tosubstitute any transitional phrase with any other transitional phrase,and the inventions shall be understood to include such substitutedtransitions and form part of the original written description of theinventions. Thus, for example, the term “comprising” may be replacedwith either of the transitional phrases “consisting essentially of” or“consisting of.”

The methods and processes illustratively described herein may besuitably practiced in differing orders of steps. They are notnecessarily restricted to the orders of steps indicated herein, or inthe claims.

Under no circumstances may the patent be interpreted to be limited tothe specific examples, or embodiments, or methods, specificallydisclosed herein. Under no circumstances may the patent be interpretedto be limited by any statement made by any Examiner, or any otherofficial or employee of the Patent and Trademark Office, unless suchstatement was specifically, and without qualification or reservation,expressly adopted by Applicants in a responsive writing specificallyrelating to the application that led to this patent prior to itsissuance.

The terms and expressions employed herein have been used as terms ofdescription and not of limitation, and there is no intention in the useof such terms and expressions, or any portions thereof, to exclude anyequivalents now know or later developed, whether or not such equivalentsare set forth or shown or described herein or whether or not suchequivalents are viewed as predictable, but it is recognized that variousmodifications are within the scope of the invention claimed, whether ornot those claims issued with or without alteration or amendment for anyreason. Thus, it shall be understood that, although the presentinvention has been specifically disclosed by preferred embodiments andoptional features, modifications and variations of the inventionsembodied therein or herein disclosed can be resorted to by those skilledin the art, and such modifications and variations are considered to bewithin the scope of the inventions disclosed and claimed herein.

Specific methods and compositions described herein are representative ofpreferred embodiments and are exemplary of, and not intended aslimitations on, the scope of the invention. Other objects, aspects, andembodiments will occur to those skilled in the art upon consideration ofthis specification, and are encompassed within the spirit of theinvention as defined by the scope of the claims. Where examples aregiven, the description shall be construed to include, but not to belimited to, only those examples. It will be readily apparent to oneskilled in the art that varying substitutions and modifications may bemade to the invention disclosed herein, without departing from the scopeand spirit of the invention, and from the description of the inventions,including those illustratively set forth herein, it is manifest thatvarious modifications and equivalents can be used to implement theconcepts of the present invention, without departing from its scope. Aperson of ordinary skill in the art will recognize that changes can bemade in form and detail without departing from the spirit and the scopeof the invention. The described embodiments are to be considered in allrespects as illustrative and not restrictive. Thus, for example,additional embodiments are within the scope of the invention and withinthe following claims.

While this invention has been disclosed with reference to specificembodiments, it is apparent that other embodiments and variations ofthis invention can be devised by those skilled in the art, withoutdeparting from the true spirit and scope of the invention. The appendedclaims include all such embodiments and equivalent variations.

The invention claimed is:
 1. A method of treating cancer modulated bythe gamma-glutamyl cycle in a human subject in need thereof comprisingadministering to the subject, a therapeutically effective amount of apharmaceutical composition consisting essentially of a stereoisomericgamma-glutamyl cycle inhibitor (GGCI) of formula (I):

or pharmaceutically acceptable salts thereof, wherein: R isindependently selected from para-methoxyphenyl, ortho-hydroxy phenyl, orphenyl; R2 is COOH; R3 and R4 are each methyl, and a pharmaceuticallyacceptable carrier, diluent, or excipient, wherein the therapeuticallyeffective amount of the stereoisomeric GGCI of formula (I) ranges from0.1 to 20 mg/kg/day.
 2. The method of claim 1, wherein the GGCI is a5-oxoproline analog.
 3. The method of claim 1, whereby the reaction stepcatalyzed by 5-oxoprolinase in the GGC cycle is inhibited.
 4. The methodof claim 2, whereby the level of glutathione is reduced in cancer cells.5. The method according to claim 1, wherein the stereoisomericgamma-glutamyl cycle inhibitor (GGCI) of formula (I) inhibitsglutathione-S-transferase.
 6. The method of claim 1, wherein the one ormore effective doses of GGCI are administered subcutaneously,intravenously, or intramuscularly.
 7. The method of claim 1, wherein theone or more effective doses of GGCI are administered orally.
 8. Themethod of claim 1, wherein the cancer is a solid tumor.
 9. The method ofclaim 8, wherein the solid tumor comprises sarcomas, carcinomas, orlymphomas.
 10. The method of claim 9, wherein the cancer is selectedfrom the group consisting of: lung, breast, prostate, pancreatic,ovarian, bladder, head and neck, thyroid, brain, skin and kidney. 11.The method of claim 1, wherein the stereoisomeric gamma-glutamyl cycleinhibitor has a structure of Formula (III):


12. The method of claim 2, wherein the 5-oxoproline analog has astructure of Formula (IV):


13. The method of claim 2, wherein the 5-oxoproline analog has astructure of Formula (V):


14. A method of reducing the prostate specific antigen (PSA) level in ahuman subject having prostate cancer, the method comprisingadministering to the subject a therapeutically effective amount of apharmaceutical composition consisting essentially of a stereoisomericgamma-glutamyl cycle inhibitor (GGCI) of formula (I):

or pharmaceutically acceptable salts thereof, wherein: R isindependently selected from para-methoxyphenyl, ortho-hydroxy phenyl, orphenyl; R2 is COOH; R3 and R4 are each methyl, and a pharmaceuticallyacceptable carrier, diluent, or excipient, wherein the therapeuticallyeffective amount of the stereoisomeric GGCI of formula (I) ranges from0.1 to 20 mg/kg/day.
 15. The method of claim 14, wherein the PSA levelis reduced by over 164 ng/mL in the subject.
 16. The method of claim 15,wherein the PSA level reduction occurs within 3 weeks of administeringthe stereoisomeric gamma-glutamyl cycle inhibitor (GGCI) of formula (I).17. The method of claim 14, wherein the PSA level is reduced by over 322ng/mL.
 18. The method of claim 14, wherein the stereoisomericgamma-glutamyl cycle inhibitor (GGCI) of formula (I) has a structureselected from formula (III), formula (IV), or formula (V);


19. The method of claim 1 or 14, wherein the subject has previouslyreceived hormonal therapy.
 20. The method of claim 19, wherein thehormonal therapy comprises administration of tamoxifen, tamoxifencitrate, raloxifene, droloxifene, 4-hydroxytamoxifen, trioxifene,keoxifene, LY117018, onapristone, or toremifine citrate.